Evaluation of Carbohydrate and Fiber Consumption in Patients With Irritable Bowel Syndrome in Outpatient Treatment

Abstract

BACKGROUND: Irritable bowel syndrome (IBS) is a chronic functional condition, which main symptoms of pain, discomfort and abdominal distension, constipation, diarrhea, altered fecal consistency and sensation of incomplete evacuation can be influenced by the presence of dietary fiber and fermentable carbohydrates (FODMAPs). This study aimed to assess the relationship between the quantity of fermentable carbohydrates (FODMAP) and fiber consumed by individuals diagnosed with IBS, and their classification according to the Rome III criteria. METHODS: A transversal study was carried out in the Intestinal Outpatient Clinic of the Gastroenterology Discipline of UNIFESP. The nutrients of interest for the study were: fiber, general carbohydrates and FODMAPs, with intake quantity measured in grams, analyzed through portions consumed. A nutrition log was used, along with a semi-quantitative questionnaire of consumption frequency. RESULTS: The sample included 63 adult patients; 21 with constipated IBS, 21 with diarrhea IBS, and 21 with mixed IBS. Carbohydrate intake was suboptimal in 55.6% of patients in all groups; excessive consumption was identified in 38.1% of the diarrhea group, 14.3% of the mixed group and 38.1% of the constipated group. Low consumption of carbohydrates was found in 28.6% of diarrhea patients and 47.6% of the mixed group. A mean intake of 23 g of fiber per day was identified, lower than recommended. CONCLUSION: The study identified a number of inadequacies in the consumption of different nutrients, excessive carbohydrate intake, especially FODMAPs, identified by the respondents as responsible for a worsening of their conditions. By contrast, other food groups such as meat, eggs and dairy were consumed by the sample population in insufficient quantities.

A systematic review and meta‐analysis of diet and nutrient intake in adults with irritable bowel syndrome

“…A total of 23,643 citations were retrieved from which 7639 duplicates were removed using EndNote 20 and Covidence, resulting in a final set of 16,004 citations/abstracts for review. Following screening, 615 articles were retrieved for full‐text review from which 63 full‐text articles comprised of 52,105 participants ( N = 8720 IBS, N = 43,385 controls) were ultimately included 11,14,15,43–102 . Agreement between authors was almost perfect (kappa statistic = 0.96).…”

Impactos da Síndrome do Intestino Irritável associada à ansiedade e depressão na qualidade de vida da população

“…Em contrapartida, a ingestão de fibras é muito indicada para pacientes que sofrem de constipação, os quais podem se beneficiar em termos de frequência evacuatória, quando associada a ingestão de água e exercícios físicos. Ademais, auxilia em casos de diarreia controlando o peristaltismo intestinal, sendo muito benéfico também o monitoramento dos hábitos alimentares antes de fazer recomendações (Lopes et al, 2019) (Passos et al, 2020).…”

Dieta Low Fodmaps: Opção De Tratamento Não Farmacológico Na Síndrome Do Intestino Irritável

“…A avaliação inicial deve se concentrar na observação dos hábitos alimentares, orientando as recomendações com base nos resultados obtidos. Para alguns pacientes, uma dieta com baixo teor de gordura e restrição de alimentos produtores de gases pode ser benéfica (LOPES et al, 2019).…”

“…Em alguns casos, mesmo com a melhoria na frequência evacuatória, alguns pacientes continuam a experimentar dor. Além disso, essa abordagem pode ser útil para pacientes com diarreia, auxiliando no controle do peristaltismo intestinal e na formação de fezes mais compactas (LOPES et al, 2019).…”