Liens entre alimentation et syndrome de l’intestin irritable

Relations between nutrition and irritable bowel syndrome

Résumé

Un rôle de l’alimentation est suggéré par deux tiers des patients avec Syndrome de l’intestin irritable (SII). Les mécanismes en cause sont multiples: allergie vraie (rare) ou intolérance alimentaire, hypersensibilité au gluten (avec ou sans maladie coeliaque), effet des lipides (rétention de gaz ou modification de la sensibilité rectale), intolérance au lactose ou effet des FODMAPs (favorisant des fermentations). La prise de certains probiotiques et/ou des conseils diététiques adaptés peuvent parfois améliorer les symptômes. Malgré des évictions alimentaires fréquentes les carences nutritionnelles sont rares.

Abstract

A role of diet is suggested by two thirds of patients with irritable bowel syndrome (IBS). The mechanisms involved are multiple: true allergy (rare) or food intolerance, gluten sensitivity (with or without celiac disease), effect of lipids (gas retention or change in rectal sensitivity), lactose intolerance or effect of FODMAPs (osmotic effect and fermentation). Some probiotics and/or dietary guidelines can improve symptoms. Despite frequent evictions food nutritional deficiencies are rare in IBS patients compared with general population.

This is a preview of subscription content, access via your institution.

Références

  1. 1.

    Dapoigny M. (2009) Irritable bowel syndrome: epidemiology/ economic burden. Gastroenterol Clin Biol 33:Suppl 1:S3–S8.

    PubMed  Article  Google Scholar 

  2. 2.

    Gralnek IM, Hays RD, Kilbourne A, et al (2000) The impact of irritable bowel syndrome on health-related quality of life. Gastroenterology 119:654–660.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Ford AC, Talley NJ. (2011) IBS in 2010: advances in pathophysiology, diagnosis and treatment. Nat Rev Gastroenterol Hepatol 8:76–78.

    PubMed  Article  Google Scholar 

  4. 4.

    Gasbarrini A, Lauritano EC, Garcovich M, et al (2008) New insights into the pathophysiology of IBS: intestinal microflora, gas production and gut motility. Eur Rev Med Pharmacol Sci 12Suppl 1:111–117.

    PubMed  Google Scholar 

  5. 5.

    Spiller R, Aziz Q, Creed F, et al (2007) Guidelines on the irritable bowel syndrome: mechanisms and practical management. Gut 56:1770–1798.

    PubMed  Article  CAS  Google Scholar 

  6. 6.

    Heizer WD, Southern S, McGovern S. (2009) The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review. J Am Diet Assoc 109:1204–1214.

    PubMed  Article  Google Scholar 

  7. 7.

    Simren M, Mansson A, Langkilde AM, et al (2001) Food-related gastrointestinal symptoms in the irritable bowel syndrome. Digestion 63:108–115.

    PubMed  CAS  Google Scholar 

  8. 8.

    Kanazawa M, Fukudo S. (2006) Effects of fasting therapy on irritable bowel syndrome. Int J Behav Med 13:214–220.

    PubMed  Article  Google Scholar 

  9. 9.

    Miwa H. (2012) Life style in persons with functional gastrointestinal disorders—large-scale internet survey of lifestyle in Japan. Neurogastroenterol Motil 24:464–471, e217.

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Saito YA, Locke GR, III, Weaver AL, et al (2005) Diet and functional gastrointestinal disorders: a population-based case-control study. Am J Gastroenterol 100:2743–2748.

    PubMed  Article  Google Scholar 

  11. 11.

    Williams EA, Nai X, Corfe BM. (2011) Dietary intakes in people with irritable bowel syndrome. BMC Gastroenterol 11:9.

    PubMed  Article  Google Scholar 

  12. 12.

    Bohn L, Storsrud S, Simren M. (2012) Nutrient intake in patients with irritable bowel syndrome compared with the general population. Neurogastroenterol Motil 10.

    Google Scholar 

  13. 13.

    Monsbakken KW, Vandvik PO, Farup PG. (2006) Perceived food intolerance in subjects with irritable bowel syndrome—etiology, prevalence and consequences. Eur J Clin Nutr 60:667–672.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Ligaarden SC, Lydersen S, Farup PG. (2012) IgG and IgG4 antibodies in subjects with irritable bowel syndrome: a case control study in the general population. BMC Gastroenterol 12:166. doi: 10.1186/1471-230X-12-166:166-12.

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    Jung HJ, Park MI, Moon W, et al (2011) Are Food Constituents Relevant to the Irritable Bowel Syndrome in Young Adults? — A Rome III Based Prevalence Study of the Korean Medical Students. J Neurogastroenterol Motil 17:294–299.

    PubMed  Article  Google Scholar 

  16. 16.

    Ostgaard H, Hausken T, Gundersen D, et al (2012) Diet and effects of diet management on quality of life and symptoms in patients with irritable bowel syndrome. Mol Med Rep 5:1382–1390.

    PubMed  Google Scholar 

  17. 17.

    Carroccio A, Brusca I, Mansueto P, et al (2010) A cytologic assay for diagnosis of food hypersensitivity in patients with irritable bowel syndrome. Clin Gastroenterol Hepatol 8:254–260.

    PubMed  Article  Google Scholar 

  18. 18.

    Zuo XL, Li YQ, Li WJ, et al (2007) Alterations of food antigenspecific serum immunoglobulins G and E antibodies in patients with irritable bowel syndrome and functional dyspepsia. Clin Exp Allergy 37:823–830.

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Zar S, Mincher L, Benson MJ, et al (2005) Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome. Scand J Gastroenterol 40:800–807.

    PubMed  Article  Google Scholar 

  20. 20.

    Atkinson W, Sheldon TA, Shaath N, et al (2004) Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut 53:1459–1464.

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    van der Wouden EJ, Nelis GF, Vecht J. (2007) Screening for coeliac disease in patients fulfilling the Rome II criteria for irritable bowel syndrome in a secondary care hospital in The Netherlands: a prospective observational study. Gut 56:444–445.

    PubMed  Article  Google Scholar 

  22. 22.

    Biesiekierski JR, Newnham ED, Irving PM, et al (2011) Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial. Am J Gastroenterol 106:508–514.

    PubMed  Article  CAS  Google Scholar 

  23. 23.

    Bijkerk CJ, Muris JW, Knottnerus JA, et al (2004) Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 19:245–251.

    PubMed  Article  CAS  Google Scholar 

  24. 24.

    Ford AC, Talley NJ, Spiegel BM, et al (2008) Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ 337:a2313. doi: 10.1136/bmj.a2313.:a2313.

    PubMed  Article  Google Scholar 

  25. 25.

    Simren M, Abrahamsson H, Bjornsson ES. (2001) An exaggerated sensory component of the gastrocolonic response in patients with irritable bowel syndrome. Gut 48:20–27.

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    Simren M, Abrahamsson H, Bjornsson ES. (2007) Lipid-induced colonic hypersensitivity in the irritable bowel syndrome: the role of bowel habit, sex, and psychologic factors. Clin Gastroenterol Hepatol 5:201–208.

    PubMed  Article  Google Scholar 

  27. 27.

    Serra J, Azpiroz F, Malagelada JR. (2001) Impaired transit and tolerance of intestinal gas in the irritable bowel syndrome. Gut 48:14–19.

    PubMed  Article  CAS  Google Scholar 

  28. 28.

    Serra J, Salvioli B, Azpiroz F, et al (2002) Lipid-induced intestinal gas retention in irritable bowel syndrome. Gastroenterology 123:700–706.

    PubMed  Article  Google Scholar 

  29. 29.

    Bouchoucha M, Devroede G, Raynaud JJ, et al (2011) Is the colonic response to food different in IBS in contrast to simple constipation or diarrhea without abdominal pain? Dig Dis Sci 56:2947–2956.

    PubMed  Article  Google Scholar 

  30. 30.

    Bohmer CJ, Tuynman HA. (1996) The clinical relevance of lactose malabsorption in irritable bowel syndrome. Eur J Gastroenterol Hepatol 8:1013–1016.

    PubMed  Article  CAS  Google Scholar 

  31. 31.

    Vernia P, Ricciardi MR, Frandina C, et al (1995) Lactose malabsorption and irritable bowel syndrome. Effect of a long-term lactose-free diet. Ital J Gastroenterol 27:117–121.

    PubMed  CAS  Google Scholar 

  32. 32.

    Bohmer CJ, Tuynman HA. (2001) The effect of a lactoserestricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: a 5-year followup study. Eur J Gastroenterol Hepatol 13:941–944.

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Parker TJ, Woolner JT, Prevost AT, et al (2001) Irritable bowel syndrome: is the search for lactose intolerance justified? Eur J Gastroenterol Hepatol 13:219–225

    PubMed  Article  CAS  Google Scholar 

  34. 34.

    Lisker R, Solomons NW, Perez BR, et al (1989) Lactase and placebo in the management of the irritable bowel syndrome: a double-blind, cross-over study. Am J Gastroenterol 84:756–762.

    PubMed  CAS  Google Scholar 

  35. 35.

    Barrett JS, Gearry RB, Muir JG, et al (2010) Dietary poorly absorbed, short-chain carbohydrates increase delivery of water and fermentable substrates to the proximal colon. Aliment Pharmacol Ther 31:874–882.

    PubMed  CAS  Google Scholar 

  36. 36.

    Ong DK, Mitchell SB, Barrett JS, et al (2010) Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol 25:1366–1373.

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Shepherd SJ, Parker FC, Muir JG, et al (2008) Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clin Gastroenterol Hepatol 6:765–771.

    PubMed  Article  CAS  Google Scholar 

  38. 38.

    Staudacher HM, Lomer MC, Anderson JL, et al (2012) Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr 142:1510–1518.

    PubMed  Article  CAS  Google Scholar 

  39. 39.

    Staudacher HM, Whelan K, Irving PM, et al (2011) Comparison of symptom response following advice for a diet low in fermentable carbohydrates (FODMAPs) versus standard dietary advice in patients with irritable bowel syndrome. J Hum Nutr Diet 10–277X.

    Google Scholar 

  40. 40.

    Pettinger C, Holdsworth M, Gerber M. (2004) Psycho-social influences on food choice in Southern France and Central England. Appetite 42:307–316.

    PubMed  Article  CAS  Google Scholar 

  41. 41.

    Pettinger C, Holdsworth M, Gerber M. (2006) Meal patterns and cooking practices in Southern France and Central England. Public Health Nutr 9:1020–1026.

    PubMed  Article  Google Scholar 

  42. 42.

    Pettinger C, Holdsworth M, Gerber M. (2008) All under one roof?’ differences in food availability and shopping patterns in Southern France and Central England. Eur J Public Health 18:109–114.

    PubMed  Article  Google Scholar 

  43. 43.

    Whorwell PJ, Altringer L, Morel J, et al (2006) Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome. Am J Gastroenterol 101:1581–1590.

    PubMed  Article  Google Scholar 

  44. 44.

    Guyonnet D, Chassany O, Ducrotte P, et al (2007) Effect of a fermented milk containing Bifidobacterium animalis DN-173 010 on the health-related quality of life and symptoms in irritable bowel syndrome in adults in primary care: a multicentre, randomized, double-blind, controlled trial. Aliment Pharmacol Ther 26:475–486.

    PubMed  Article  CAS  Google Scholar 

  45. 45.

    Moayyedi P, Ford AC, Talley NJ, et al (2010) The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut 59:325–332.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to J. -M. Sabaté.

Additional information

INSERM U987 physiopathologie et pharmacologie clinique de la douleur ; Président du Conseil Scientifique de l’APSSII (Association de Patients Souffrant du Syndrome de l’Intestin Irritable)

About this article

Cite this article

Sabaté, J.M. Liens entre alimentation et syndrome de l’intestin irritable. Colon Rectum 7, 86–92 (2013). https://doi.org/10.1007/s11725-013-0457-7

Download citation

Mots clés

  • Syndrome intestin irritable
  • Alimentation
  • Allergie alimentaire
  • FODMAPs
  • Gluten
  • Lactose

Keywords

  • Irritable bowel syndrome
  • Nutrition
  • Food allergy
  • FODMAPs
  • Gluten
  • Lactose