Dispepsi Semptomlarının Yönetiminde Beslenmenin Rolü

Dispepsi karın bölgesindeki "rahatsızlık hissi" olarak tanımlanır ve dolgunluk hissi, erken doyma, bulantı, geğirti, şişkinlik gibi semptomları vardır. Organik dispepside yakınmaların anatomik ya da patofizyolojik nedeni saptanabilirken, fonksiyonel dispepside herhangi bir organik, sistemik ve metabolik neden bulunamamaktadır. Dispepsi patogenezinde fizyolojik, genetik, çevresel ve psikolojik etmenler etkili iken diyet ve yaşam tarzı etmenleri de semptomları etkileyebilmektedir. Dispepsili hastalar birçok besinin tüketimi ile hastalık şikayetlerini ilişkilendirmektedir. Tüketilen besinlerin içerikleri kadar, öğün sayısı, sıklığı, yemek yeme hızı da semptomları etkileyebilmektedir. Dispepsinin beslenme tedavisinde diyetin yağ içeriğinin azaltılması, besinlerin iyi pişirilmesi ve baharatlı olmaması, yemekle birlikte fazla sıvı alınmaması, öğünlerde tüketilen miktarın az ve enerji yoğunluğunun düşük olması önem taşımaktadır. Beslenme tedavisinde FODMAP diyeti gibi alternatif yollar da izlenebilmektedir. Sonuç olarak, dispepsinin hem patofizyolojisinde hem de tedavisinde beslenme önemli rol oynamaktadır

The Role of Nutrition in the Management of Dyspepsia Symptoms

Dyspepsia is defined as “feeling of discomfort” in the abdomen and has symptoms such as fullness, early satiety, nausea, fatigue, bloating. Although the anatomical or pathophysiological cause of organic dyspepside complaints can be detected, organic, systemic and metabolic causes of functional dyspepsia can not been found. While physiological, genetic, environmental and psychological factors are effective in the pathogenesis of dyspepsia, dietary and lifestyle factors can also affect symptoms. Patients with dyspepsia associates consumption of many foods with disease complaints. As well as the content of consumed foods, the number and frequency of meals, speed of eating can affect symptoms. In the nutritional therapy of dyspepsia, reducing the fat content of diet, consuming well cooked and unseasoned foods, not taking too much liquid with meals, small and low energy density meals are important. Alternative ways such as FODMAP diet can be followed in nutritional therapy. It can be concluded that nutrition plays an important role both in pathophysiology and treatment of dyspepsia

Kaynakça

1. Çelik AF. Dispepsiye Yaklaşım. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri Sempozyum Dizisi 2007;50:31-42.

2. Çetin F, Aygün C, Erman F, Aydin S, Poyrazoğlu OK, Bahçecioğlu İH. Fonksiyonel dispepside obestatin ve ghrelinin rolü. Akademik Gastroenteroloji Dergisi 2009;8(3):102-107.

3. Birol Ö. Fonksiyonel Dispepsi. İç Hastalıkları Dergisi 2011;18:153-157.

4. Köksal AŞ, Dilek O, Özden A. Türkiye’de birinci basamak sağlık kurumlarına başvuran hastalarda dispepsi görülme sıklığı. Akademik Gastroenteroloji Dergisi 2008;7(1):11-17.

5. Saka M, Köseler E, Metin S. Gastrointestinal Sistem Hastalıkları ve Beslenme Tedavisi. Alphan ET, editör. Hastalıklarda Beslenme Tedavisi. Ankara: Hatiboğlu Yayınevi; 2013, s.541-638.

6. Adibi P, Keshteli AH, Esmaillzadeh A, Afshar H, Roohafza H, Bagherian-Sararoudi R, et al. The study on the epidemiology of psychological, alimentary health and nutrition (SEPAHAN): overview of methodology. J Res Med Sci 2012;17:291-297.

7. Nihat O, Yılmaz Ö, Dursun H, Polat G, Gürsan N, Çayır K. Dispeptik semptomlarla beslenme alışkanlıkları, endoskopik ve histolojik bulgular arasındaki ilişki. Akademik Gastroenteroloji Dergisi 2006;5(2):110-115.

8. Carvalho RVB, Lorena SLS, de Souza Almeida JR, Mesquita MA. Food intolerance, diet composition, and eating patterns in functional dyspepsia patients. Dig Dis Sci 2010;55(1):60-65.

9. Lee SY, Masaoka T, Han H, Matsuzaki J, Hong M, Fukuhara S, et al. A prospective study on symptom generation according to spicy food intake and TRPV1 genotypes in functional dyspepsia patients. Neurogastroenterol Motil 2016;28(9):1401-1408.

10. Saneei P, Sadeghi O, Feizi A, Keshteli AH, Daghaghzadeh H, Esmaillzadeh A, et al. Relationship between spicy food intake and chronic uninvestigated dyspepsia in Iranian adults. J Dig Dis 2016;17(1):28-35.

11. Masoumi SJ, Mehrabani D, Moradi F, Zare N, SaberiFirouzi M, Mazloom Z. The prevalence of dyspepsia symptoms and its correlation with the quality of life among Qashqai Turkish migrating nomads in Fars Province, Southern Iran. Pak J Med Sci 2015;31(2):325- 330.

12. Chirila I, Morariu ID, Barboi OB, Drug VL. The role of diet in the overlap between gastroesophageal reflux disease and functional dyspepsia. Turk J Gastroenterol 2016;27(1):73-80.

13. Bharucha AE, Camilleri M, Burton DD, Thieke SL, Feuerhak KJ, Basu A, et al. Increased nutrient sensitivity and plasma concentrations of enteral hormones during duodenal nutrient infusion in functional dyspepsia. Am J Gastroenterol 2014;109(12):1910-1920

14. Petrarca L, Nenna R, Mastrogiorgio G, Florio M, Brighi M, Pontone S. Dyspepsia and celiac disease: Prevalence, diagnostic tools and therapy. World J Methodol 2014;4(3):189-196.

15. Faria M, Pavin EJ, Parisi MCR, Nagasako CK, Mesquita MA. Dyspeptic symptoms in patients with type 1 diabetes: endoscopic findings, Helicobacter pylori infection, and associations with metabolic control, mood disorders and nutritional factors. Arch Endocrinol Metab 2015;59(2):129-136.

16. Talley NJ. Functional dyspepsia: new insights into pathogenesis and therapy. Korean J Intern Med 2016;31(3):444-456.

17. Jáuregui Lobera I, Santed M, Bolaños Ríos P. Impact of functional dyspepsia on quality of life in eating disorder patients: the role of thought-shape fusion. Nutr Hosp 2011;26(6):1363-1371.

18. Bouchoucha M, Fysekidis M, Julia C, Airinei G, Catheline J-M, Cohen R, et al. Body mass index association with functional gastrointestinal disorders: differences between genders. Results from a study in a tertiary center. J Gastroenterol 2016;51(4):337-345.

19. Jiang SM, Lei XG, Jia L, Xu M, Wang SB, Liu J, et al. Unhealthy dietary behavior in refractory functional dyspepsia: a multicenter prospective investigation in China. J Dig Dis 2014;15(12):654-659.

20. Farré R, Vanheel H, Vanuytsel T, Masaoka T, Törnblom H, Simrén M, et al. In functional dyspepsia, hypersensitivity to postprandial distention correlates with meal-related symptom severity. Gastroenterology 2013;145(3):566-573.

21. Sinn DH, Shin DH, Lim SW, Kim K-M, Son HJ, Kim JJ, et al. The speed of eating and functional dyspepsia in young women. Gut and Liver 2010;4(2):173-178.

22. Adibi P, Keshteli AH, Saneei M, Saneei P, Savabi O, Esmaillzadeh A. Relationship between tooth loss, functional dyspepsia and gastro-esophageal reflux disorder among Isfahani adults. AIM 2016;19(2):123- 130.

23. Akbulut AGG, Çiftçi AGH, Yıldız E. Sindirim Sistemi Hastalıkları ve Beslenme Tedavisi. Sağlık Bakanlığı Yayını Şubat 2008; No:728.

24. Özcan C, Oral SS, Öksüz E, Kut A, Erdal R. Genç erişkinlerde dispepsi yakınmasının yaşam kalitesine etkisi. Smyrna Tıp Dergisi 2012;1:2-12.

25. Ianiro G, Pizzoferrato M, Franceschi F, Tarullo A, Luisi T, Gasbarrini G. Effect of an extra-virgin olive oil enriched with probiotics or antioxidants on functional dyspepsia: a pilot study. Eur Rev Med Pharmacol Sci 2013;17(15):2085-2090.

26. Pen J. Diet in the etiology and management of functional dyspepsia. In: Shaffer E, Curley M, editors. Dyspepsia - Advances in Understanding and Management. Rijeka: InTech; 2013. p. Ch. 06.

27. Aksoy M. Ansiklopedik Beslenme, Diyet ve Gıda Sözlüğü. Ankara: Hatiboğlu Yayınevi; 2007.

28. Tan VP. The low-FODMAP diet in the management of functional dyspepsia in East and Southeast Asia. J Gastroenterol Hepatol 2017;32 Suppl 1(S1):46-52.

29. Patcharatrakul T, Gonlachanvit S. Chili peppers, curcumins, and prebiotics in gastrointestinal health and disease. Current Gastroenterology Reports 2016;18(4):1-11.

30. Gonlachanvit S. Are rice and spicy diet good for functional gastrointestinal disorders? J Neurogastroenterol Motil 2010;16(2):131-138.

31. Santolaria S, Alcedo J, Cuartero B, Diez I, Abascal M, García-Prats MD, et al. Spectrum of gluten-sensitive enteropathy in patients with dysmotility-like dyspepsia. Gastroenterol Hepatol 2013;36(1):11-20.

32. Park SY. Is lipase supplementation before a high fat meal helpful to patients with functional dyspepsia? Gut and Liver 2015;9(4):433-434.

33. Kusano M, Zai H, Hosaka H, Shimoyama Y, Nagoshi A, Maeda M, et al. Monosodium L-glutamate added to a high-energy, high-protein liquid diet promotes gastric emptying: a possible therapy for patients with functional dyspepsia. J Pharmacol Sci 2010;112(1):33-6.

34. Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther 2002;16(6):1075-82.

35. Führer M, Vogelsang H, Hammer J. A placebo‐ controlled trial of an oral capsaicin load in patients with functional dyspepsia. Neurogastroenterol Motil 2011;23(10):918-927.

36. Giacosa A, Guido D, Grassi M, Riva A, Morazzoni P, Bombardelli E, et al. The effect of ginger (Zingiber officinalis) and artichoke (Cynara cardunculus) extract supplementation on functional dyspepsia: a randomised, double-blind, and placebo-controlled clinical trial. Evid Based Complement Alternat Med 2015;2015:1-9.

37. Holtmann G, Adam B, Haag S, Collet W, Grünewald E, Windeck T. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six‐ week placebo‐controlled, double‐blind, multicentre trial. Aliment Pharmacol Ther 2003;18(11‐12):1099- 1105.

38. Yap P, Mahadeva S, Goh K-L. The influence of cultural habits on the changing pattern of functional dyspepsia. Dig Dis 2014;32(3):217-221.

39. Akhondi-Meybodi M, Aghaei MA, Hashemian Z. The role of diet in the management of non-ulcer dyspepsia. Middle East J Dig Dis 2015;7(1):19-24.

Kaynak Göster