Tags

Type your tag names separated by a space and hit enter

Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial.
Clin Gastroenterol Hepatol 2017; 15(5):712-719.e4CG

Abstract

BACKGROUND & AIMS

We sought to determine the efficacy of psyllium fiber treatment on abdominal pain and stool patterns in children with irritable bowel syndrome (IBS). We evaluated effects on breath hydrogen and methane production, gut permeability, and microbiome composition. We also investigated whether psychological characteristics of children or parents affected the response to treatment.

METHODS

We performed a randomized, double-blind trial of 103 children (mean age, 13 ± 3 y) with IBS seen at primary or tertiary care settings. After 2 weeks on their habitual diet, children began an 8-day diet excluding carbohydrates thought to cause symptoms of IBS. Children with ≥75% improvement in abdominal pain were excluded (n = 17). Children were assigned randomly to groups given psyllium (n = 37) or placebo (maltodextrin, n = 47) for 6 weeks. Two-week pain and stool diaries were compared at baseline and during the final 2 weeks of treatment. We assessed breath hydrogen and methane production, intestinal permeability, and the composition of the microbiome before and after administration of psyllium or placebo. Psychological characteristics of children were measured at baseline.

RESULTS

Children in the psyllium group had a greater reduction in the mean number of pain episodes than children in the placebo group (mean reduction of 8.2 ± 1.2 after receiving psyllium vs mean reduction of 4.1 ± 1.3 after receiving placebo; P = .03); the level of pain intensity did not differ between the groups. Psychological characteristics were not associated with response. At the end of the study period, the percentage of stools that were normal (Bristol scale scores, 3-5), breath hydrogen or methane production, intestinal permeability, and microbiome composition were similar between groups.

CONCLUSIONS

Psyllium fiber reduced the number of abdominal pain episodes in children with IBS, independent of psychological factors. Psyllium did not alter breath hydrogen or methane production, gut permeability, or microbiome composition. ClinicalTrials.gov no: NCT00526903.

Authors+Show Affiliations

Department of Pediatrics, Baylor College of Medicine; Children's Nutrition Research Center; Texas Children's Hospital. Electronic address: rshulman@bcm.edu.Texas Children's Hospital; Texas Children's Microbiome Center; Department of Pathology and Immunology, Baylor College of Medicine; Department of Pathology, Texas Children's Hospital.Department of Biostatistics and Office of Nursing Research, University of Washington, Seattle, Washington.Texas Children's Hospital; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine.Texas Children's Hospital; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine.Department of Pediatrics, Baylor College of Medicine; Children's Nutrition Research Center; Texas Children's Hospital.Texas Children's Hospital; Texas Children's Microbiome Center; Department of Pathology and Immunology, Baylor College of Medicine; Department of Pathology, Texas Children's Hospital.Texas Children's Hospital; Texas Children's Microbiome Center; Department of Pathology and Immunology, Baylor College of Medicine; Department of Pathology, Texas Children's Hospital.Texas Children's Hospital; Texas Children's Microbiome Center; Department of Pathology and Immunology, Baylor College of Medicine; Department of Pathology, Texas Children's Hospital.Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27080737

Citation

Shulman, Robert J., et al. "Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial." Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, vol. 15, no. 5, 2017, pp. 712-719.e4.
Shulman RJ, Hollister EB, Cain K, et al. Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. Clin Gastroenterol Hepatol. 2017;15(5):712-719.e4.
Shulman, R. J., Hollister, E. B., Cain, K., Czyzewski, D. I., Self, M. M., Weidler, E. M., ... Heitkemper, M. (2017). Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association, 15(5), pp. 712-719.e4. doi:10.1016/j.cgh.2016.03.045.
Shulman RJ, et al. Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. Clin Gastroenterol Hepatol. 2017;15(5):712-719.e4. PubMed PMID: 27080737.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial. AU - Shulman,Robert J, AU - Hollister,Emily B, AU - Cain,Kevin, AU - Czyzewski,Danita I, AU - Self,Mariella M, AU - Weidler,Erica M, AU - Devaraj,Sridevi, AU - Luna,Ruth Ann, AU - Versalovic,James, AU - Heitkemper,Margaret, Y1 - 2016/04/11/ PY - 2016/03/14/received PY - 2016/03/14/accepted PY - 2016/4/16/pubmed PY - 2018/1/3/medline PY - 2016/4/16/entrez KW - Abdominal Pain KW - Fiber KW - Irritable Bowel Syndrome KW - Microbiome KW - Psyllium SP - 712 EP - 719.e4 JF - Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association JO - Clin. Gastroenterol. Hepatol. VL - 15 IS - 5 N2 - BACKGROUND & AIMS: We sought to determine the efficacy of psyllium fiber treatment on abdominal pain and stool patterns in children with irritable bowel syndrome (IBS). We evaluated effects on breath hydrogen and methane production, gut permeability, and microbiome composition. We also investigated whether psychological characteristics of children or parents affected the response to treatment. METHODS: We performed a randomized, double-blind trial of 103 children (mean age, 13 ± 3 y) with IBS seen at primary or tertiary care settings. After 2 weeks on their habitual diet, children began an 8-day diet excluding carbohydrates thought to cause symptoms of IBS. Children with ≥75% improvement in abdominal pain were excluded (n = 17). Children were assigned randomly to groups given psyllium (n = 37) or placebo (maltodextrin, n = 47) for 6 weeks. Two-week pain and stool diaries were compared at baseline and during the final 2 weeks of treatment. We assessed breath hydrogen and methane production, intestinal permeability, and the composition of the microbiome before and after administration of psyllium or placebo. Psychological characteristics of children were measured at baseline. RESULTS: Children in the psyllium group had a greater reduction in the mean number of pain episodes than children in the placebo group (mean reduction of 8.2 ± 1.2 after receiving psyllium vs mean reduction of 4.1 ± 1.3 after receiving placebo; P = .03); the level of pain intensity did not differ between the groups. Psychological characteristics were not associated with response. At the end of the study period, the percentage of stools that were normal (Bristol scale scores, 3-5), breath hydrogen or methane production, intestinal permeability, and microbiome composition were similar between groups. CONCLUSIONS: Psyllium fiber reduced the number of abdominal pain episodes in children with IBS, independent of psychological factors. Psyllium did not alter breath hydrogen or methane production, gut permeability, or microbiome composition. ClinicalTrials.gov no: NCT00526903. SN - 1542-7714 UR - https://www.unboundmedicine.com/medline/citation/27080737/Psyllium_Fiber_Reduces_Abdominal_Pain_in_Children_With_Irritable_Bowel_Syndrome_in_a_Randomized_Double_Blind_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-3565(16)30021-0 DB - PRIME DP - Unbound Medicine ER -