Carbohydrate Elimination or Adaptation Diet for Symptoms of Intestinal Discomfort in IBD Rationales for “Gibsons’ Conundrum”英文文献资料.docVIP

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Carbohydrate Elimination or Adaptation Diet for Symptoms of Intestinal Discomfort in IBD Rationales for “Gibsons’ Conundrum”英文文献资料.doc

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Carbohydrate Elimination or Adaptation Diet for Symptoms of Intestinal Discomfort in IBD Rationales for “Gibsons’ Conundrum”英文文献资料

HindawiPublishingCorporation InternationalJournalofIn?ammation Volume2012,ArticleID493717,19pages doi:10.1155/2012/493717 ReviewArticle CarbohydrateEliminationorAdaptationDiet forSymptomsofIntestinalDiscomfortinIBD:Rationales for“Gibsons’Conundrum” Q.ManyanFungandAndrewSzilagyi DivisionofGastroenterology,DepartmentofMedicine,JewishGeneralHospital,McGillUniversitySchoolofMedicine, 3755C?ote-Sainte-CatherineRoad,RoomE110,Montreal,QC,CanadaH3T1E2 CorrespondenceshouldbeaddressedtoAndrewSzilagyi,aszilagy@gas.jgh.mcgill.ca Received15September2011;Revised13November2011;Accepted14November2011 AcademicEditor:DavidSachar Copyright?2012Q.M.FungandA.Szilagyi.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Therapeuticuseofcarbohydratesinin?ammatoryboweldiseases(IBDs)isdiscussedfromtwotheoretical,apparentdiametrically oppositeperspectives:regularingestionofprebioticsorwithdrawalofvirtuallyallcarbohydratecomponents.PathogenesisofIBD isdiscussedconnectingmicrobial?ora,hostimmunity,andgeneticinteractions.Thebeststudiedgeneticexample,NOD2in Crohn’sdisease,ishighlightedasamodelwhichencompassestheseinteractionsandhasbeenshowntodependonbutyratefor normalfunction.Theroleoftheseopposingconceptsinmanagementofirritablebowelsyndrome(IBS)iscontrastedwithwhat isknowninIBD.Theconclusionreachedisthat,whilebothapproachesmayalleviatesymptomsinbothIBSandIBD,thereis insu?cientdatayettodeterminewhetherbothapproachesleadtoequivalentbacteriale?ectsinmollifyingtheimmunesystem. ThisisparticularlyrelevantinIBD.Assuch,cautionisurgedtouselong-termcarbohydratewithdrawalinIBDinremissionto controlIBS-likesymptoms. 1.Introduction idiopathiculcerativecolitis(UC)(thetwoclinicalsubtypesof IBD)weretargetedtocapitalizeonthepotentialtherapeutic e?ects of either pro- or prebiotics [3–5]. While CD and idiopathic UC both share somewhat similar epidemiology and are thought to have