Impacto de uma dieta com baixo teor de FODMAPs nos sintomas gastrointestinais de pacientes diagnosticados com a síndrome do intestino irritável: uma revisão sistemática da literatura

Autores

DOI:

https://doi.org/10.12957/demetra.2024.81934

Resumo

Introdução: A síndrome do intestino irritável (SII) é um distúrbio intestinal funcional crônico, caracterizado por dor abdominal recorrente e alterações nos hábitos intestinais, sem causas orgânicas claras. Como sua etiologia ainda não é totalmente compreendida, não há um tratamento universalmente aplicável a todos os pacientes. No entanto, a exclusão de FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) da dieta tem sido estudada como potencial estratégia para tratar os sintomas da doença. Objetivo: Este estudo objetivou investigar os efeitos da dieta com baixo teor de FODMPs (DBTF) nos sintomas gastrointestinais de pacientes diagnosticados com SII. Método: Trata-se de uma revisão sistemática da literatura nas bases de dados PubMed, Lilacs, Medline, Biblioteca Virtual em Saúde (BVS), ScienceDirect e Embase, utilizando combinações de descritores com base na estratégia PICO. Foram selecionados 11 ensaios controlados randomizados publicados nos últimos dez anos (2013-2023), com adultos diagnosticados com SII. Foram excluídos estudos que utilizaram outras intervenções dietéticas além da DBTF, aqueles realizados com pacientes diagnosticados com outros distúrbios intestinais e que não avaliaram sintomas gastrointestinais. Resultados: A DBTF se mostrou eficaz na redução dos sintomas da SII, promovendo uma diminuição notável na intensidade e frequência da dor abdominal e distensão. No entanto, os pacientes seguindo a DBTF apresentaram menor ingestão de energia e fibras, sugerindo a necessidade de acompanhamento nutricional. Ademais, a adoção dessa dieta resultou na diminuição da população de Bifidobacterium, devido à exclusão de fibras. Conclusão: Este estudo sustenta que a DBTF é uma estratégia nutricional eficaz para aliviar sintomas gastrointestinais em adultos com SII.

Downloads

Não há dados estatísticos.

Biografia do Autor

Mateus Siqueira, Centro Universitário de Viçosa – Univiçosa, Centro de Ciências da Saúde, Curso de Nutrição. Viçosa, MG, Brasil.

Graduando em Nutrição.

Luciana Marques Vieira , Centro Universitário de Viçosa – Univiçosa, Centro de Ciências da Saúde, Curso de Nutrição. Viçosa, MG, Brasil.

Pós-doutorado em Ciência e Tecnologia de Alimentos; Docente em Nutrição.

Referências

Martins A, Pequito A, Baltazar, AL. Disbiose intestinal e síndrome do intestino irritável: efeito de uma dieta baixa em FODMAPs. Acta portuguesa de nutrição. 2020;22:38-41. https://dx.doi.org/10.21011/apn.2020.2207

Andrade VLA, Fonseca TN, Gouveia CA, Kobayashi TG, Leite RGS, Matar RA, et al.Dieta restrita de FODMAPs como opção terapêutica na síndrome do intestino irritável: revisãosistemática. GED gastroenterol. endosc. dig. 2015;34(1):34-41.

Oliveira PDTM, Reis JEF, Reis MAS, Ferreira SMS, Candelária ALAA. Dieta com restrição de FODMAP reduz os sintomas no síndroma do intestino irritável? Uma revisão baseada na evidência. Ver Port Med Geral Fam. 2020;36(2):126-34. https://doi.org/10.32385/rpmgf.v36i2.12545

Makker J, Chilimuri S, Bella JN. Genetic epidemiology of irritable bowel syndrome. World Journal of Gastroenterology. 2015;21(40):11353-61. https://doi.org/10.3748/wjg.v21.i40.11353

Mendonça APM, Yamashita LM, Silva ED, Solar I, Santos LAO, Vasques ACJ. Nutritional status, quality of life and life habits of women with irritable bowel syndrome: a case-control study. Arq Gastroenterol. 2020;57(2):114-20. https://doi.org/10.1590/S0004-2803.202000000-22

Santos RB, Sales VC, Debia N, Barros LR, Martins MCC. Efeitos da restrição de FOODMAPs na redução de sintomas da síndrome do intestino irritável. Pesquisas e Ações em Saúde Pública. 2022;1(4):188-95. https://doi.org/10.29327/560779.4-26

Nadai R, Melo C, Custódio JP, Ferreira FB, Clara APHSC, Trindade LZ, Martins FQ, Signorelli IV. Transplante de microbiota fecal no tratamento da síndrome do intestino irritável: uma revisão sistemática. Arq Med Hosp Fac Cienc Med Santa Casa São Paulo. 2017;62(3):156-59. https://doi.org/10.26432/1809-3019.2017.62.3.156

Murillo AZ, Arévalo FE, Jáuregui EP. Diet low in fermentable oligosaccharides, disaccharides, monosaccharides andpolyols (FODMAPs) in the treatment of irritable bowel syndrome: Indications and design. Endocrinol Nutr. 2016;63(3):132-38. https://doi.org/10.1016/j.endonu.2015.10.009.

Paje MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. British Medical Journal. 2021;372(160). https://doi.org/10.1136/bmj.n160

Turco R, Salvatore S, Miele E, Romano C, Marseglia GL, Staiano A. Does a low FODMAPs diet reduce symptoms of functional abdominal pain disorders? A systematic review in adult and paediatric population, on behalf of Italian Society of Pediatrics. Italian Journal of Pediatrics. 2018; 44(1):43-67. https://doi.org/10.1186/s13052-018-0495-8

Eswaran SL, Chey WD, Han-Markey T, Ball S, Jackson KA. A Randomized Controlled Trial Comparing the Low FODMAP Diet vs. Modified NICE Guidelines in US Adults with IBS-D. American Journal of Gastroenterology 2016;111(12):1824-32. https://doi.org/10.1038/ajg.2016.434

Halmos PE, Power VA, Shepherd SJ, Gibson PR, Muir JGA. A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome. Gastroenterology. 2014;146(1):67-75. https://doi.org/10.1053/j.gastro.2013.09.046

Patcharatrakul T, Juntrapirat A, Lakananurak N, Gonlachanvit S. Effect of Structural Individual Low-FODMAP Dietary Advice vs. Brief Advice on a Commonly Recommended Diet on IBS Symptoms and Intestinal Gas Production. Nutrients. 2019;11(12):2856-68. https://doi.org/10.3390/nu11122856

Algera JP, Demir D, Tornblom H, Nybacka S, Simren M, Storsrud S. Low FODMAP diet reduces gastrointestinal symptoms in irritable bowel syndrome and clinical response could be predicted by symptoms severity: A randomized crossover trial. Clinical Nutrition. 2022;41(12):2792-800. https://doi.org/10.1016/j.clnu.2022.11.001

Mcintosh K, Reed DE, Schneider T, Dang F, Keshteli AH, Palma G, et al. FODMAPs alter symptoms and the metabolome of patients with IBS: a randomized controlled trial. Gut. 2017;66(7):1241-51. https://doi.org/10.1136/gutjnl-2015-311339

Böhn L, Störsrud S, Liljebo T, Collin L, Lindlofors P, Törnblom H, et al. Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome as Well as Traditional Dietary Advice: A Randomized Controlled Trial. Gastroenterology. 2015;149(6):1399-407. https://doi.org/10.1053/j.gastro.2015.07.054

Zhang Y, Feng L, Wang X, Fox M, Luo L, Du L, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet compared with traditional dietary advice for diarrhea-predominant irritable bowel syndrome: a parallel-group, randomized controlled trial with analysis of clinical and microbiological factors associated with patient outcomes. The American Journal of Clinical Nutrition. 2021;113(6):1531-545. https://doi.org/10.1093/ajcn/nqab005

Harvie RM, Chisholm AW, Bisanz JE, Burton JP, Herbison P, Schultz K, et al. Long-term irritable bowel syndrome symptom control with reintroduction of selected FODMAPs. World Journal of Gastroenterology. 2017;23(25):4632-643. https://doi.org/10.3748/wjg.v23.i25.4632

Russo F, Riezzo G, Orlando A, Linsalata M, D'attoman B, Prospero L, et al. A Comparison of the Low-FODMAPs Diet and a Tritordeum-Based Diet on the Gastrointestinal Symptom Profile of Patients Suffering from Irritable Bowel Syndrome-Diarrhea Variant (IBS-D): A Randomized Controlled Trial. Nutrients. 2022;14(8):1544-559. https://doi.org/10.3390/nu14081544

Staudacher HM, Lomer MCE, Farquharson FM, Louis P, Fava F, Franciosi E, et al. A Diet Low in FODMAPs Reduces Symptoms in Patients with Irritable Bowel Syndrome and A Probiotic Restores Bifidobacterium Species: a Randomized Controlled Trial. Gastroenterology. 2017;153(4):936-47. https://doi.org/10.1053/j.gastro.2017.06.010

Zahedi MJ, Behrouz V, Azimi M. Low FODMAPs diet vs. general dietary advice improves clinical response in patients with diarrhea-predominant irritable bowel syndrome: a randomized controlled trial. J Gastroenterol Hepatol. 2018 Jun;33(6):1192-199. https://doi.org/10.1111/jgh.14051.

Gibson PR. History of the low FODMAP diet. Journal of Gastroenterology and Hepatology. 2017;32(1):5-7. https://doi.org/10.1111/jgh.13685

Barrett JS. How to institute the low-FODMAP diet. Journal of Gastroenterology and Hepatology. 2017;32(1):8-10. https://doi.org/10.1111/jgh.13686

Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. Journal of Gastroenterology and Hepatology. 2010;25(2):252-58. https://doi.org/10.1111/j.1440-1746.2009.06149.x

Ireton-Jones C. The low FODMAP diet: fundamental therapy in the management of irritable bowel syndrome. Current Opinion in Clinical Nutrition and Metabolic Care. 2017;20(5):414-19. https://doi.org/10.1097/MCO.0000000000000398

Murillo AZ, Arévalo FE, Jáuregui EP. Diet low in fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) in the treatment of irritable bowel syndrome: Indications and design. Endocrinol Nutr. 2016;63(3):132-38. https://doi.org/10.1016/j.endonu.2015.10.009

Staudacher HM, Whelan K, Irving PM, Lomer MCE. Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. Journal of Human Nutrition and Dietetics. 2011;24(5):487-95. https://doi.org/10.1111/j.1365-277X.2011.01162.x

Altobelli E, Negro VD, Angeletti PM, Latella G. Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis. Nutrients. 2017;9(9):940-59. https://doi.org/10.3390/nu9090940

Belline M, Tonarelli S, Nagy AG, Pancetti A, Costa F, Ricchiuti A, et al. Low FODMAP Diet: Evidence, Doubts, and Hopes. Nutrients. 2020;4(12):148-69. https://doi.org/10.3390/nu12010148

Kasti A, Petsis K, Lambrinou S, Katsas K, Nikolaki M, Papanikolaou LS, et al. A Combination of Mediterranean and Low-FODMAP Diets for Managing IBS Symptoms? AskYourGut! Microorganisms. 2022;10(4):751-63. https://doi.org/10.3390/microorganisms10040751

Staudacher H, Ross FS, Briscoe ZM, Irving PM, Whelan K, Lomer MC. PTU-183 Advice from a dietitian regarding the low fodmap diet broadly maintains nutrient intake and does not alter fibre intake. Gut. 2015;64(1). http://dx.doi.org/10.1136/gutjnl-2015-309861.298

Staudacher HM, Lomer MCE, Anderson JL, Barret JS, Muir JG, Irving PM, et al. Fermentable Carbohydrate Restriction Reduces Luminal Bifidobacteria and Gastrointestinal Symptoms in Patients with Irritable Bowel Syndrome. The Journal of Nutrition. 2012;142(8):1510-518. https://doi.org/10.3945/jn.112.159285

Hustoft TN, Hausken T, Ystad SO, Valeur J, Brokstad K, Hatlebakk JG, et al. Effects of varying dietary content of fermentable short-chain carbohydrates on symptoms, fecal microenvironment, and cytokine profiles in patients with irritable bowel syndrome. Neurogastroenterology and Motility. 2016;29(4). https://doi.org/10.1111/nmo.12969

Bennet SMP, Böhn L, Störsrud S, Liljebo, T, Collin L, Lindfors P, et al. Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs. Gut. 2017;67(5):872-81. https://doi.org/10.1136/gutjnl-2016-313128

Staudacher HM, Rossi M, Kaminski T, Dimidi E, Ralph FSE, Wilson B, et al. Long-term personalized low FODMAP diet improves symptoms and maintains luminal Bifidobacteria abundance in irritable bowel syndrome. Neurogastroenterology and Motility. 2021;34(4). https://doi.org/10.1111/nmo.14241

Marsh A, Eslick EM, Eslick GD. Does a diet low in FODMAPs reduce symptoms associated with functional gastrointestinal disorders? A comprehensive systematic review and meta analysis. European Journal of Nutrition. 2016;55(3):897-906. https://doi.org/10.1007/s00394-015-0922-1

Staudacher HM, Irving PM, Lomer MC, Whelan K. Mechanisms and efficacy of dietary FODMAP restriction in IBS. Nature Reviews Gastroenterology and Hepatology. 2014;11(4):256-66. https://doi.org/10.1038/nrgastro.2013.259

Salhy ME. Recent developments in the pathophysiology of irritable bowel syndrome. Mundial Journal of Gastroenterology. 2015;21(25):7621-636. https://doi.org/10.3748/wjg.v21.i25.7621

Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016;150(6):1262-279. https://doi.org/10.1053/j.gastro.2016.02.032

Wong RKM, Drossman DA. Quality of life measures in irritable bowel syndrome. Expert Rev Gastroenterol Hepatol. 2010;4(3):277-84. https://doi.org/10.1586/egh.10.19

Larussa T, Suraci E, Marasco R, Imeneo M, Abenavoli L, Luzza F. Self-Prescribed Dietary Restrictions are Common in Inflammatory Bowel Disease Patients and Are Associated with Low Bone Mineralization. Medicina. 2019;55(8):507-20. https://doi.org/10.3390/medicina55080507

Publicado

2024-10-14

Como Citar

Siqueira, M., & Vieira , L. M. (2024). Impacto de uma dieta com baixo teor de FODMAPs nos sintomas gastrointestinais de pacientes diagnosticados com a síndrome do intestino irritável: uma revisão sistemática da literatura. DEMETRA: Alimentação, Nutrição & Saúde, 19, e81934. https://doi.org/10.12957/demetra.2024.81934

Edição

Seção

Nutrição Clínica