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Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis.
BMJ 2008; 337:a2313BMJ

Abstract

OBJECTIVE

To determine the effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome.

DESIGN

Systematic review and meta-analysis of randomised controlled trials.

DATA SOURCES

Medline, Embase, and the Cochrane controlled trials register up to April 2008. Review methods Randomised controlled trials comparing fibre, antispasmodics, and peppermint oil with placebo or no treatment in adults with irritable bowel syndrome were eligible for inclusion. The minimum duration of therapy considered was one week, and studies had to report either a global assessment of cure or improvement in symptoms, or cure of or improvement in abdominal pain, after treatment. A random effects model was used to pool data on symptoms, and the effect of therapy compared with placebo or no treatment was reported as the relative risk (95% confidence interval) of symptoms persisting.

RESULTS

12 studies compared fibre with placebo or no treatment in 591 patients (relative risk of persistent symptoms 0.87, 95% confidence interval 0.76 to 1.00). This effect was limited to ispaghula (0.78, 0.63 to 0.96). Twenty two trials compared antispasmodics with placebo in 1778 patients (0.68, 0.57 to 0.81). Various antispasmodics were studied, but otilonium (four trials, 435 patients, relative risk of persistent symptoms 0.55, 0.31 to 0.97) and hyoscine (three trials, 426 patients, 0.63, 0.51 to 0.78) showed consistent evidence of efficacy. Four trials compared peppermint oil with placebo in 392 patients (0.43, 0.32 to 0.59).

CONCLUSION

Fibre, antispasmodics, and peppermint oil were all more effective than placebo in the treatment of irritable bowel syndrome.

Authors+Show Affiliations

Gastroenterology Division, McMaster University, Health Sciences Centre, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada. alexf12399@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

19008265

Citation

Ford, Alexander C., et al. "Effect of Fibre, Antispasmodics, and Peppermint Oil in the Treatment of Irritable Bowel Syndrome: Systematic Review and Meta-analysis." BMJ (Clinical Research Ed.), vol. 337, 2008, pp. a2313.
Ford AC, Talley NJ, Spiegel BM, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ. 2008;337:a2313.
Ford, A. C., Talley, N. J., Spiegel, B. M., Foxx-Orenstein, A. E., Schiller, L., Quigley, E. M., & Moayyedi, P. (2008). Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. BMJ (Clinical Research Ed.), 337, pp. a2313. doi:10.1136/bmj.a2313.
Ford AC, et al. Effect of Fibre, Antispasmodics, and Peppermint Oil in the Treatment of Irritable Bowel Syndrome: Systematic Review and Meta-analysis. BMJ. 2008 Nov 13;337:a2313. PubMed PMID: 19008265.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. AU - Ford,Alexander C, AU - Talley,Nicholas J, AU - Spiegel,Brennan M R, AU - Foxx-Orenstein,Amy E, AU - Schiller,Lawrence, AU - Quigley,Eamonn M M, AU - Moayyedi,Paul, Y1 - 2008/11/13/ PY - 2008/11/15/pubmed PY - 2008/12/17/medline PY - 2008/11/15/entrez SP - a2313 EP - a2313 JF - BMJ (Clinical research ed.) JO - BMJ VL - 337 N2 - OBJECTIVE: To determine the effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase, and the Cochrane controlled trials register up to April 2008. Review methods Randomised controlled trials comparing fibre, antispasmodics, and peppermint oil with placebo or no treatment in adults with irritable bowel syndrome were eligible for inclusion. The minimum duration of therapy considered was one week, and studies had to report either a global assessment of cure or improvement in symptoms, or cure of or improvement in abdominal pain, after treatment. A random effects model was used to pool data on symptoms, and the effect of therapy compared with placebo or no treatment was reported as the relative risk (95% confidence interval) of symptoms persisting. RESULTS: 12 studies compared fibre with placebo or no treatment in 591 patients (relative risk of persistent symptoms 0.87, 95% confidence interval 0.76 to 1.00). This effect was limited to ispaghula (0.78, 0.63 to 0.96). Twenty two trials compared antispasmodics with placebo in 1778 patients (0.68, 0.57 to 0.81). Various antispasmodics were studied, but otilonium (four trials, 435 patients, relative risk of persistent symptoms 0.55, 0.31 to 0.97) and hyoscine (three trials, 426 patients, 0.63, 0.51 to 0.78) showed consistent evidence of efficacy. Four trials compared peppermint oil with placebo in 392 patients (0.43, 0.32 to 0.59). CONCLUSION: Fibre, antispasmodics, and peppermint oil were all more effective than placebo in the treatment of irritable bowel syndrome. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/19008265/full_citation L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=19008265 DB - PRIME DP - Unbound Medicine ER -