Ecem ALTINOK, Eda AYDIN, Süeda KOVAL, Ayşegül İpek ÖZBİLGİN, Burcu ŞENER, Öznur Özge ÖZCAN, Hatice ÇOLAK, Esra Tansu SARIYER, Ekin ÇEVİK, Mesut KARAHAN

İrritabl Bağırsak Sendromu Olan Hastalarda Beslenme Durumunun İncelenmesi

İrritabl bağırsak sendromu, abdominal ağrı, gaz, şişkinlik ve bağırsak alışkanlığının değişmesi ile karakterize kronik fonksiyonel bir gastrointestinal bozukluktur. Çeşitli diyet yaklaşımları ve beslenme alışkanlıkları hastalığın semptomlarıyla ilişkili olabilmektedir. Bu çalışmanın amacı, irritabl bağırsak sendromu bulunan hastaların beslenme alışkanlıklarının incelenmesi ve sağlıklı bireylerin beslenme alışkanlıkları ile karşılaştırılmasıdır. Bu amaçla, çalışmaya Mart-Nisan 2020 tarihleri arasında online erişim ile gerçekleştirilen çalışmaya Roma IV kriterlerine göre irritabl bağırsak sendromu tanısı almış 40 hasta ile sağlıklı 40 kontrol alındı. Bireylerin demografik özellikleri, beden kitle indeksi, beslenme alışkanlıkları ve besin tüketim sıklığına ilişkin veriler anket formu ile toplandı. Veriler SPSS 25.0 Programı ile analiz edilerek istatistiksel anlamlılık için p<0,05 değeri kabul edildi. Çalışmaya katılan hastaların %80’i kadın ve beden kitle indeks ortalaması 24,73±3,88 kg/m2 ve irritabl bağırsak sendromu tanısı konma süresi ortalama 6,15±6,83 yıl olarak saptandı. Sağlıklı bireylerle karşılaştırıldığında hastaların yaş ve beden kitle indeksi anlamlı olarak daha fazla bulundu (p<0,05). Hastaların %17,5’i probiyotik tüketirken; sağlıklı bireylerin hiçbirinin tüketmediği belirlendi, aradaki fark anlamlı bulundu (p<0,05). Hastalık tanısı alma durumuna göre et, balık ve tavuk; ekmek, tahıl ve kuru baklagiller; yumurta tüketimi arasındaki farklar anlamlı bulundu (p<0,05). Sonuç olarak, irritabl bağırsak sendromu olan hastalar, sağlıklı bireylere göre, semptomları tetikleyecek besinleri tüketmemeye eğilimli iken; probiyotik kullanımı gibi semptomları hafifletebilecek davranışlar sergilemektedir. Buna göre, irritabl bağırsak sendromu tedavisinde sağlıklı beslenme alışkanlıkları edinmek hastalığın prognozunu olumlu etkilemektedir.

Anahtar Kelimeler:

İrritabl bağırsak sendromu, Beslenme, Obezite, Probiyotik

Investigation of Nutrition Status in Patients with Irritable Bowel Syndrome

Irritable bowel syndrome is a chronic functional gastrointestinal disorder characterized by abdominal pain, bloating, distension and altered bowel habits. Some dietary approaches and eating habits may be associated with the symptoms of the disease. The aim of the study is to examine the eating habits of patients with irritable bowel syndrome and to compare them with the eating habits of healthy individuals. For this purpose, 40 patients diagnosed with irritable bowel syndrome according to Rome IV criteria and 40 healthy controls were included in the study, which was conducted online between March and April 2020. Data on demographic characteristics, body mass index, nutritional habits and frequency of food consumption of individuals were collected with a questionnaire form. The data were analyzed with SPSS 25.0 program and p <0.05 was accepted for statistical significance. 80% of the patients participating in the study were female and the average body mass index is 24.73 ± 3.88 kg / m2 and the duration of diagnosis of irratable bowel syndrome is 6.15 ± 6.83 years on average. Age and body mass index of the patients are significantly higher (p <0.05) compared to healthy individuals. While 17.5% of the patients consumed probiotics; it was determined that none of the healthy individuals consumed; the difference was found to be significant (p <0.05). According to the disease diagnosis, difference between of meat, fish and chicken; bread, cereals and legumes; egg consumption was statistically significant (p <0.05). In conclusion, avoiding foods that may bother these patients from the diet and using probiotics can alleviate irritable bowel syndrome symptoms. Accordingly, adopting healthy eating habits positively affects the prognosis of the disease in the treatment of irritable bowel syndrome.

Keywords:

Irritable bowel syndrome, Nutrition, Obesity, Probiotic,

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1. Kaya M, Kaçmaz H. Roma IV kriterlerine göre fonksiyonel barsak hastalıklarının yeniden değerlendirilmesi. Güncel Gastroenteroloji. 2016; 20(4): 393-407.
2. El-Salhy M, Gundersen D. Diet in irritable bowel syndrome. Nutrition journal. 2015; 14(1): 1-11.
3. Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and metaanalysis. The Lancet Gastroenterology & Hepatology. 2020; online.
4. Karabayraktar T, Ahıshalı E, Dolapçıoğlu C. Obezite ve İrritabl Bağırsak Sendromu. J Kartal TR, 2014; 25(2): 127-32.
5. Ozer M, Bengi G, Colak R, Cengiz O, Akpinar H. Prevalence of irritable bowel syndrome-like symptoms using Rome IV criteria in patients with inactive inflammatory bowel disease and relation with quality of life. Medicine. 2020; 99(19): e20067.
6. Canavan C, West J, Card T. The epidemiology of irritable bowel syndrome, Clınıcal Epıdemıology. 2014; 6: 71–80.
7. Mullin GE, Shepherd SJ, Chander Roland B, Ireton-Jones C, Matarese LE. Irritable bowel syndrome: contemporary nutrition management strategies. Journal of Parenteral and Enteral Nutrition, 2014; 38(7): 781-799.
8. Creed F. Review article: the incidence and risk factors for irritable bowel syndrome in population-based studies. Aliment Pharmacol Ther. 2019; 50: 507-516.
9. Flacco ME, Manzoli L, De Giorgio R, Gasbarrini A, Cicchetti A, Bravi F, Ursini F. Costs of irritable bowel syndrome in European countries with universal healthcare coverage: a meta-analysis. 2019; 23: 2986-3000.
10. Tap J, Derrien M, Törnblom H, Brazeilles R, Cools-Portier S, Doré J, Störsrud S, Le Nevé B, Öhman L, Simrén M. Identification of an Intestinal Microbiota Signature Associated With Severity of Irritable Bowel Syndrome. Gastroenterology 2017; 152: 111–123.
11. Simrén M, Törnblom H, Palsson OS, Whitehead W. Management of the multiple symptoms of irritable bowel syndrome. Lancet Gastroenterol. Hepatol. 2017; 2: 112–122.
12. Algera J, Colomier E, Simrén M. The dietary management of patients with irritable bowel syndrome: a narrative review of the existing and emerging evidence. Nutrients. 2019; 11(9): 2162.
13. Nilholm C, Larsson E, Roth B, Gustafsson R, Ohlsson B. Irregular dietary habits with a high intake of cereals and sweets are associated with more severe gastrointestinal symptoms in IBS patients. Nutrients. 2019; 11(6): 1279.
14. Özdemir M, Perktaş G. İrritable Bağırsak Sendromunda Diyet. Güncel Gastroenteroloji. 2016; 20(3): 274-279.
15. Moayyedi P, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, Soer EE, Spiegel BM, Ford AC. The effect of fiber supplementation on irritable bowel syndrome: A systematic review and meta-analysis. Am. J. Gastroenterol. 2014; 109: 1367–1374.
16. Müller M, Canfora EE, Blaak EE. Gastrointestinal Transit Time, Glucose Homeostasis and Metabolic Health: Modulation by Dietary Fibers. Nutrients 2018: 10; 1–18.
17. Staudacher HM, Lomer MCE, Farquharson FM, 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):936-947.
18. Hill C, Guarner F, Reid G. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506-514.
19. Niu HL, Xiao JY. The efficacy and safety of probiotics in patients with irritable bowel syndrome: Evidence based on 35 randomized controlled trials. International Journal of Surgery. 2020: 75; 116-127.
20. Dimidi E, Whelan K. Food supplements and diet as treatment options in irritable bowel syndrome. Neurogastroenterology & Motility. 2020; 32(8): e13951.
21. Okami Y, Kato T, Nin G, Harada K, Aoi W, Wada S. Lifestyle and psychological factors related to irritable bowel syndrome in nursing and medical school students. J Gastroenterol. 2011; 46: 1403–1410.
22. Mulak A, Tache Y, Larauche M. Sex hormones in the modulation of irritable bowel syndrome. World J Gastroenterol. 2014; 20: 2433–2448.
23. Camilleri M. Sex as a biological variable in irritable bowel syndrome. Neurogastroenterology & Motility, 2020; e13802.
24. Kosako M, Akiho H, Miwa H, Kanazawa M, Fukudo S. Impact of symptoms by gender and age in Japanese subjects with irritable bowel syndrome with constipation (IBS-C): a large population-based internet survey. Biopsychosoc Med. 2018; 12: 12.
25. Zaribaf F, Keshteli AH, Esmaillzadeh A, Saneei P, Feizi A, Daghaghzadeh H, Adibi P. Empirically derived dietary habits are associated with irritable bowel syndrome. European journal of clinical nutrition. 2018; 72(11): 1537-1547.
26. Saneei P, Esmaillzadeh A, Keshteli AH, Feizi A, Feinle-Bisset C, Adibi P. Patterns of dietary habits in relation to obesity in Iranian adults. Eur J Nutr. 2016; 55: 713–728.
27. Pugliese G, Muscogiuri G, Barrea L, Laudisio D, Savastano S, Colao A. Irritable bowel syndrome: a new therapeutic target when treating obesity?. Hormones. 2019; 18(4): 395-399.
28. Talley NJ, Howell S, Poulton R. Obesity and chronic gastrointestinal tract symptoms in young adults: a birth cohort study. Am J Gastroenterol. 2004; 99: 1807–1814.
29. Salari-Moghaddam A, Hassanzadeh Keshteli A, Esmaillzadeh A, Adibi P. Water consumption and prevalence of irritable bowel syndrome among adults. Plos one. 2020; 15(1): e0228205.
30. Simrén M, Månsson A, Langkilde AM, Svedlund J, Abrahamsson H, Bengtsson U, Björnsson ES. Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion. 2001; 63(2): 108-115.
31. Soltani S, Keshteli AH, Esmaillzadeh A, Adibi P. Food Item Avoidance of Patients with Irritable Bowel Syndrome Compared with Healthy People. Archives of Iranian medicine. 2019; 22(7): 369-375.
32. Zhan YL, Zhan YA, Dai SX. Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review, Clinical Nutrition, 2018; 37(1): 123-129.
33. Ustaoğlu T, Tek NA, Yıldırım AE. İrritabl Bağırsak Sendromunda (İBS) FODMAP Diyetinin İBS Semptomları, Beslenme Durumu ve Yaşam Kalitesi Üzerine Etkilerinin Değerlendirilmesi. Beslenme ve Diyet Dergisi. 2020; 1-12.
34. Baştürk A, Artan R, Yılmaz A. Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: A randomized controlled trial. The Turkısh Journal Of Gastroenterology. 2016; 27: 439-443.
35. Silk DB, Davis A, Vulevic J, Tzortzis G, Gibson GR. Clinical trial: the effects of a transgalactooligosaccharide prebiotic on faecal microbiota And Symptoms İn İrritable Bowel Syndrome. Alımentary Pharmacology & Therapeutıcs. 2009; 29(5): 6508–6518.
36. Ford AC, Harris LA, Lacy BE, Quigley EMM, Moayyedi P. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment Pharmacol Ther. 2018;48(10):1044-1060.