Treatment Effects of Partially Hydrolyzed Guar Gum on Symptoms and Quality of Life of Patients with Irritable Bowel Syndrome. A Multicenter Randomized Open Trial

Parisi, Giancarlo; Bottona, E.; Carrara, M.; Cardin, Franco; Faedo, Alessandra; Goldin, D; Marino, Marco; Pantalena, Maurizio; Tafner, G; Verdianelli, Giorgio; Zilli, M.; Leandro, Gioacchino

doi:10.1007/s10620-005-2713-7

Cited by 42 publications

(50 citation statements)

References 36 publications

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“…56 The main component of PHGG is galactomannan, which softens stool, improves fecal output, and increases bulk capacities. 57 PHGG treatment in IBS children found a reduced frequency in IBS symptoms, but pain intensity was not decreased. 24 Results of an open-label PHGG trial in adult patients with IBS produced significant improvements in gastrointestinal symptoms, quality of life, and psychological distress, but the effects tended to diminish after the 12-week treatment period.…”

Section: Alternative Medicinementioning

confidence: 84%

“…24 Results of an open-label PHGG trial in adult patients with IBS produced significant improvements in gastrointestinal symptoms, quality of life, and psychological distress, but the effects tended to diminish after the 12-week treatment period. 57 Malabsorption and intolerance to carbohydrates such as fructose and lactose are believed to cause symptoms such as bloating, diarrhea, and abdominal pain. 55 However, neither lactose nor fructose intolerance was established as a cause of pain in 220 children with RAP in a recent study, 58 and lactose restriction did not improve symptoms in pediatric trials.…”

Section: Alternative Medicinementioning

confidence: 99%

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Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

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BACKGROUND AND OBJECTIVE: Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine.METHODS: Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach.RESULTS: Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P , .05). Guar gum significantly improved irritable bowel syndrome symptom frequency; however, no effect was found for other fiber supplements (relative risk: 1.17 [95% confidence interval: 0.75 to 1.81]) or a lactose-free diet. Functional disability was not significantly decreased after yoga compared with a wait-list approach. No studies were found concerning lifestyle interventions; gluten-, histamine-, or carbonic acid-free diets; fluid intake; or prebiotics. No serious adverse effects were reported. The quality of evidence was found to be very low to moderate. CONCLUSIONS:Although high-quality studies are lacking, some evidence shows efficacy of hypnotherapy, cognitive behavioral therapy, and probiotics (LGG and VSL#3) in pediatric AP-FGIDs. Data on fiber supplements are inconclusive.

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Section: Alternative Medicinementioning

confidence: 84%

Section: Alternative Medicinementioning

confidence: 99%

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

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“…Using lactulose breath tests (LBT), Pimental and colleagues showed that 78% of IBS patients had SIBO [128] and that eradication with a seven-day course of neomycin was associated with a significant reduction in symptoms [129] . However, these results are somewhat controversial, as both the accuracy of the LBT and its ability to gauge treatment response has been questioned [130][131][132][133] . More recently, Posserud and colleagues conducted a study of 162 IBS patients using cultures of jejunal aspirates to detect SIBO [134] .…”

Section: Antibioticsmentioning

confidence: 99%

Updates on treatment of irritable bowel syndrome

Hammerle¹,

Surawicz²

2008

WJG

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Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain and discomfort in association with altered bowel habits. It is estimated to affect 10%-15% of the Western population, and has a large impact on quality of life and (in)direct healthcare costs. IBS is a multifactorial disorder involving dysregulation within the brain-gut axis, and it is frequently associated with gastrointestinal motor and sensory dysfunction, enteric and central nervous system irregularities, neuroimmune dysregulation, and postinfectious inflammation. As with other functional medical disorders, the treatment for IBS can be challenging. Conventional therapy for those with moderate to severe symptoms is largely unsatisfactory, and the development of new and effective drugs is made difficult by the complex pathogenesis, variety of symptoms, and lack of objective clinical findings that are the hallmark of this disorder. Fortunately, research advances over the past several decades have provided insight into potential mechanisms responsible for the pathogenesis of IBS, and have led to the development of several promising pharmaceutical agents. In recent years there has been much publicity over several of these new IBS medications (alosetron and tegaserod) because of their reported association with ischemic colitis and cardiovascular disease. While these agents remain available for use under restricted prescribing programs, this highlights the need for continued development of safe and effective medication for IBS. This article provides a physiologicallybased overview of recently developed and frequently employed pharmaceutical agents used to treat IBS, and discusses some non-pharmaceutical options that may be beneficial in this disorder.

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“…9,21 Guar gum is a mucilage derived from the seeds of the Indian cluster bean Cyamopsis tetragonolobus and used in food processing as a thickener and emulsion stabilizer. 9,22 Soluble fiber is derived primarily from fruits and grains; oats are 50% soluble. 18 Soluble fiber produces viscous solutions that delay gastric emptying and small intestinal absorption and are fermented, in the proximal colon, by bacteria to a greater extent than insoluble fiber.…”

Section: Fibermentioning

confidence: 99%

“…There have been a number of trials of either fiber supplementation or bulking agents for IBS 22,28,30,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] (Table 2). Most of these trials were done between 1976 and 1994.…”

Section: Fiber Trialsmentioning

confidence: 99%

The Role of Fiber in the Treatment of Irritable Bowel Syndrome

Zuckerman¹

2006

Journal of Clinical Gastroenterology

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Irritable bowel syndrome is a common clinical condition that often presents a therapeutic challenge. There is no standard therapy and a multilevel approach is recommended. A high-fiber diet is often one of these components. Many investigators have studied the effectiveness of either fiber supplementation or bulking agents in patients with irritable bowel syndrome. The purpose of this review is to summarize the current literature on the use of fiber in irritable bowel syndrome and to provide some specific recommendations. Systematic reviews of these trials have generally not found fiber to be significantly more effective than placebo at relieving global irritable bowel syndrome symptoms. There may be differences between results obtained with soluble and insoluble fiber. Adverse effects of fiber use may include abdominal discomfort and bloating. Although dietary fiber or bulking agents do not appear to be useful as sole treatment of irritable bowel syndrome, they may have a limited role in empiric therapy depending upon the patient's symptom complex, especially if constipation is the most significant symptom. The basic principles for using fiber therapy are to start with a low dose and increase slowly, to give an adequate trial and to evaluate the results early and periodically.

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Treatment Effects of Partially Hydrolyzed Guar Gum on Symptoms and Quality of Life of Patients with Irritable Bowel Syndrome. A Multicenter Randomized Open Trial

Cited by 42 publications

References 36 publications

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Updates on treatment of irritable bowel syndrome

The Role of Fiber in the Treatment of Irritable Bowel Syndrome

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