Inulin, Choline and Silymarin in the Treatment of Irritable Bowel Syndrome with Constipation—Randomized Case-Control Study

Abstract

(1) Background: Irritable bowel syndrome (IBS) is a common disease, with multiple pathophysiological mechanisms involved. A single treatment for all the patients with IBS is not possible. Prebiotics may have a beneficial effect on IBS patients with constipation. (2) Methods: A randomized cross-over case-control study was conducted, including patients with IBS and constipation (IBS-C), who were randomized into two groups receiving a specific constipation diet with or without a food supplement containing inulin, choline and silymarin (Stoptoxin®, Fiterman Pharma, Iasi, Romania). Patients were evaluated at baseline, after four and eight weeks, using a questionnaire to assess IBS symptoms. (3) Results: 51 IBS-C patients were included, of which 47 patients finished the trial (33 women, mean age 52.82 years). Adding Stoptoxin® to a diet for constipation brought extra benefits. Abdominal pain severity improved by 68.3% after the diet and Stoptoxin® (p = 0.004) and abdominal bloating severity parameter improved by 34.8% (p = 0.040). The stool number per week and the stool consistency according to the Bristol scale were improved, but without statistical significance between groups (p > 0.05). (4) Conclusions: The combination of inulin, choline and silymarin associated with a specific-constipation diet had obvious clinical beneficial effects on IBS-C patients in terms of bowel movement, abdominal pain and bloating.

Constipation-Predominant Irritable Bowel Syndrome (IBS-C): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

“…Even if both the evacuation frequency per week and the stool consistency according to the BSS improved in both groups, no significant differences were observed between the two groups. In conclusion, the combination of inulin, choline and silymarin associated with a diet specific for constipation showed clinical beneficial effects on IBS-C patients in terms of bowel movement, abdominal pain and bloating [ 99 ].…”

Gut Dysbiosis in Irritable Bowel Syndrome: A Narrative Review on Correlation with Disease Subtypes and Novel Therapeutic Implications

“…Some evidence highlighted the possible role of prebiotics such as partially hydrolyzed guar gum for the management of IBS-D-like symptoms, leading also to an increase of Bifidobacterium (p < 0.05) [150,151]. Differently, the role of soluble fibers is well-recognized in the IBS-C subgroup as having the potential to improve quality of life and regulate colonic transit, in contrast to insoluble fiber intake which increases colonic volume and may exacerbate bloating [152,153].…”

Global Trends in Research of Pain–Gut-Microbiota Relationship and How Nutrition Can Modulate This Link

“…Prebiotics can increase resistance to pathogens, the regulation of immunity, mineral absorption, and healthy intestinal function, as well as affecting metabolism and satiety. Researchers recommended that prebiotics only, or combined with probiotics, could be used as an intervention to relieve pain in various diseases for treating gastrointestinal and psychosocial health symptoms, from cancer [58] to functional bowel disorder [59,60], irritable bowel syndrome (IBS) [26,61,62], inflammatory bowel disease (IBD) [63], and constipation [64]. However, only 13 publications suggested prebiotics as a potential preventive and therapeutic approach to nutritional management in patients with chronic pain.…”