PDF(Pubmed)
Abstract：
There remains a paucity of data on the efficacy of nutritional interventions in luminal gastrointestinal disorders. This review appraises the evidence supporting dietary modification in gastroesophageal reflux disease (GERD), irritable bowel syndrome, Celiac disease, and inflammatory bowel disease. Alhough the use of elimination diets; high fat/low carb; low fermentable oligosaccharides, disaccharides, monosaccharides and polyols; and lactose-free diets in GERD have been studied, the evidence supporting their efficacy remains weak and mixed. Patients with GERD should avoid eating within 3 hours of lying recumbent. Studied dietary interventions for disorders of gut-brain interaction include low fermentable oligosaccharides, disaccharides, monosaccharides and polyols and gluten-restricted and lactose-free diets. While all can be effective in carefully, individually selected patients, the evidence for each intervention remains low. In patients with inflammatory bowel disease, enteral nutrition is established in pediatric populations as useful in reducing inflammation and partial enteral nutrition has a growing evidence base for use in adults and children. Specific carbohydrate diets and the Crohn\'s disease exclusion diet show promising evidence but require further study to validate their efficacy prior to recommendation. Overall, the evidence supporting nutritional therapy across luminal gastrointestinal disorders is mixed and often weak, with few well-designed randomized controlled trials (RCTs) demonstrating consistent efficacy of interventions. RCTs, particularly cross-over RCTs, show potential to compare dietary interventions.
摘要：
关于营养干预在腔胃肠疾病中的功效的数据仍然很少。这篇综述评估了胃食管反流病（GERD）中支持饮食调整的证据，肠易激综合征,乳糜泻,和炎症性肠病.尽管使用消除饮食；高脂肪/低碳水化合物；低可发酵寡糖，二糖，已经研究了单糖和多元醇以及GERD中的无乳糖饮食，支持其疗效的证据仍然薄弱和混杂。GERD患者应避免在卧位后3小时内进食。对肠道-大脑相互作用障碍的饮食干预研究包括低可发酵寡糖，二糖，单糖和多元醇和麸质限制和无乳糖饮食。虽然一切都可以在仔细有效，单独选择的患者，每个干预措施的证据仍然很少.在炎症性肠病患者中，肠内营养在儿科人群中被确立为有助于减少炎症,部分肠内营养在成人和儿童中的应用证据越来越多.特定的碳水化合物饮食和克罗恩病排除饮食显示了有希望的证据，但在推荐之前需要进一步研究以验证其功效。总的来说,支持跨管腔胃肠道疾病的营养治疗的证据是混合的，通常是薄弱的，很少有精心设计的随机对照试验（RCT）证明干预措施的疗效一致。RCT,特别是交叉RCT，显示出比较饮食干预的潜力。
