Tags

Type your tag names separated by a space and hit enter

Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome.
Aliment Pharmacol Ther 2004; 19(3):245-51AP

Abstract

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.

Authors+Show Affiliations

Utrecht University Medical Center, Julius Center for Primary Care and Health Sciences, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

14984370

Citation

Bijkerk, C J., et al. "Systematic Review: the Role of Different Types of Fibre in the Treatment of Irritable Bowel Syndrome." Alimentary Pharmacology & Therapeutics, vol. 19, no. 3, 2004, pp. 245-51.
Bijkerk CJ, Muris JW, Knottnerus JA, et al. Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2004;19(3):245-51.
Bijkerk, C. J., Muris, J. W., Knottnerus, J. A., Hoes, A. W., & de Wit, N. J. (2004). Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 19(3), pp. 245-51.
Bijkerk CJ, et al. Systematic Review: the Role of Different Types of Fibre in the Treatment of Irritable Bowel Syndrome. Aliment Pharmacol Ther. 2004 Feb 1;19(3):245-51. PubMed PMID: 14984370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome. AU - Bijkerk,C J, AU - Muris,J W M, AU - Knottnerus,J A, AU - Hoes,A W, AU - de Wit,N J, PY - 2004/2/27/pubmed PY - 2004/4/17/medline PY - 2004/2/27/entrez SP - 245 EP - 51 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 19 IS - 3 N2 - 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. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/14984370/Systematic_review:_the_role_of_different_types_of_fibre_in_the_treatment_of_irritable_bowel_syndrome_ L2 - https://doi.org/10.1111/j.0269-2813.2004.01862.x DB - PRIME DP - Unbound Medicine ER -