背景：低可发酵寡头饮食，di-,单糖和多元醇（LFD）可改善肠易激综合征（IBS）患者的症状。以前的研究集中在IBS和腹泻（IBS-D）患者上。目前尚不清楚LFD对便秘型IBS（IBS-C）或混合排便习惯型IBS（IBS-M）是否有效。这个开放标签，真实世界研究评估了IBS亚型之间LFD的相对有效性。
方法：本研究分析了一项为IBS患者提供低FODMAP膳食服务的数据。参与者与注册营养师会面，并在进行2-4周的FODMAP限制之前和之后完成了IBS症状严重程度调查（IBS-SSS）。主要终点是三种IBS亚型之间IBS-SSS下降≥50点的参与者比例。
结果：在FODMAP限制之后，90％的IBS-D参与者，75%与IBS-C，84%的IBS-M达到了主要终点(p=0.045)。下降了100点，也看到了类似的改善，但IBS亚型间差异不显著(p=0.46)。在FODMAP限制之后,所有组的总IBS-SSS以及个别症状类别均有统计学显著改善.除了腹胀严重程度（IBS-M改善最大）和排便满意度（IBS-C改善较少）的类别外，各组之间IBS-SSS亚类的改善相似。
结论：尽管IBS-D的应答者比例最高，IBS-C的应答者比例最低，LFD导致所有IBS亚型的总体症状均有显著改善.关键的个体症状在所有IBS亚型中也显示出显著的改善。
BACKGROUND: A diet low in fermentable oligo-, di-, monosaccharides and polyols (LFD) improves symptoms in patients with irritable bowel syndrome (IBS). Previous studies have focused on patients with IBS and diarrhea (IBS-D). It is unclear whether LFD is effective for IBS with constipation (IBS-C) or IBS with mixed bowel habits (IBS-M). This open-label, real-world study evaluates the relative effectiveness of the LFD among IBS subtypes.
METHODS: This study analyzes data from a service that provides low-FODMAP meals to individuals with IBS. Participants met with a registered dietitian and completed the IBS symptom severity survey (IBS-SSS) before and after undergoing a 2-4-week period of FODMAP restriction. The primary endpoint was the proportion of participants with ≥50-point decrease in IBS-SSS between the three IBS subtypes.
RESULTS: After FODMAP restriction, 90% of participants with IBS-D, 75% with IBS-C, and 84% with IBS-M met the primary endpoint (p = 0.045). Similar improvement was seen for a 100-point decrease, but the difference between IBS subtypes was not significant (p = 0.46). After FODMAP restriction, all groups had statistically significant improvement in total IBS-SSS as well as individual symptom categories. Improvement in IBS-SSS subcategories was similar among the groups except for the categories of bloating severity (IBS-M had greatest improvement) and bowel movement satisfaction (IBS-C had less improvement).
CONCLUSIONS: Though the proportion of responders was highest for IBS-D and lowest for IBS-C, the LFD led to robust improvement in overall symptoms in all IBS subtypes. Key individual symptoms also showed significant improvements in all IBS subtypes.
