The problem of gas in irritable bowel syndrome

WHORWELL, P

doi:10.1016/s0002-9270(00)00961-8

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…The role of fibre in the pathophysiology of irritable bowel syndrome remains poorly understood 42 . An increase in the amount of dietary fibre is an almost universal recommendation in the primary care management of irritable bowel syndrome, 3 , 5 and guidelines on irritable bowel syndrome management for out‐clinic patients advise an increase in fibre intake in the event of constipation 5 ,.…”

Section: Discussionmentioning

confidence: 99%

Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome

Bijkerk

Muris

Knottnerus

et al. 2004

Aliment Pharmacol Ther

280

160

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Summary Background : Both high‐fibre dietary advice and the prescription of fibre as a bulking agent are very common in primary and secondary care management of irritable bowel syndrome. Irritable bowel syndrome patients with constipation may have delayed intestinal transit. Therefore, fibres that accelerate intestinal transit may be beneficial in these patients. The uncertain benefits reported in several clinical studies, however, have led us to reappraise the value of fibre in irritable bowel syndrome management. Aim : To quantify the effect of different types of fibre on global and symptom relief from irritable bowel syndrome. Methods : Using a structured literature search in MEDLINE (1966–2002), we selected randomized controlled trials involving irritable bowel syndrome patients treated with fibre. Analyses were performed for the total group and for trials using soluble and insoluble fibre separately. Results : Seventeen studies were included in the analysis. None investigated primary care irritable bowel syndrome patients. Fibre, in general, was effective in the relief of global irritable bowel syndrome symptoms [relative risk, 1.33; 95% confidence interval (CI), 1.19–1.50]. Irritable bowel syndrome patients with constipation may receive benefit from fibre treatment (relative risk, 1.56; 95% CI, 1.21–2.02), but there was no evidence that fibre was effective in the relief of abdominal pain in irritable bowel syndrome. Soluble and insoluble fibre, separately, had different effects on global irritable bowel syndrome symptoms. Soluble fibre (psyllium, ispaghula, calcium polycarbophil) showed significant improvement (relative risk, 1.55; 95% CI, 1.35–1.78), whereas insoluble fibre (corn, wheat bran), in some cases, worsened the clinical outcome, but there was no significant difference compared with placebo (relative risk, 0.89; 95% CI, 0.72–1.11). Conclusions : The benefits of fibre in the treatment of irritable bowel syndrome are marginal for global irritable bowel syndrome symptom improvement and irritable bowel syndrome‐related constipation. Soluble and insoluble fibres have different effects on global irritable bowel syndrome symptoms. Indeed, in some cases, insoluble fibres may worsen the clinical outcome. Future clinical studies evaluating the effect and tolerability of fibre therapy are needed in primary care.

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Section: Discussionmentioning

confidence: 99%

Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome

Bijkerk

Muris

Knottnerus

et al. 2004

Aliment Pharmacol Ther

280

160

View full text Add to dashboard Cite

show abstract

“…It is also regrettable that these symptoms have tended to be trivialised and dismissed as imaginary by the medical practitioner; recent studies of relationships between symptoms and quality of life in IBS attest not only to the high prevalence of these symptoms but also to the real distress associated in this disorder with bloating and distension, for example. [1][2][3][4][5][6][7] Indeed, patients will often report that they can cope with pain but cannot tolerate bloating and distension! The distressed patient and the concerned physician can now take heart; gas is being taken seriously!…”

mentioning

confidence: 99%

From comic relief to real understanding; how intestinal gas causes symptoms

Quigley¹

2003

Gut

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The problem of gas in irritable bowel syndrome

Cited by 2 publications

References 10 publications

Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome

Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome

From comic relief to real understanding; how intestinal gas causes symptoms

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