Randomized clinical study: Partially hydrolyzed guar gum (PHGG) versus placebo in the treatment of patients with irritable bowel syndrome.

E Niv,N Vaisman,A Halak,H Yanai,H Strul,E Tiommny,T Naftali

doi:10.1186/s12986-016-0070-5

Abstract

BackgroundThe treatment of Irritable bowel syndrome (IBS) is still challenging. Partially hydrolyzed guar gum (PHGG) is a known prebiotic fiber. To assess the effects of PHGG on clinical symptoms of IBS patients in a prospective randomized double blind placebo-controlled study.MethodsSuitable IBS patients were recruited into an 18-week-long study (2 weeks of run-in, 12 weeks of treatment and 4 weeks of follow-up). They were blindly randomized to receive 6 gr of PHGG or placebo. Treatment efficacy was evaluated by the Francis Severity IBS score, the IBS quality-of-life scores and scored parameters of weekly journal of symptoms. Deltas of changes between the final and baseline scores were compared between two groups.ResultsOf 121 patients who underwent randomization, 108 patients (49 in the PHGG group and 59 in the placebo group) had all the data needed for intention-to-treat analysis. A 12-week administration of PHGG led to a significant improvement of journal bloating score in the PHGG group versus placebo (−4.1±13.4 versus −1.2±11.9, P=0.03), as well as in bloating+gasses score (−4.3±10.4 versus −1.12±10.5, P = 0.035). The effect lasted for at least 4 weeks after the last PHGG administration. PHGG had no effect on other journal reported IBS symptoms or on Severity and Quality of life scores. There were no significant side effects associated with PHGG ingestion. The rate of dropouts was significantly higher among patients in the placebo group compared with the PHGG group (49.15% versus 22.45%, respectively, P = 0.01).ConclusionsThe results of this study support the administration of 6 g/day PHGG for IBS patients with bloating.Trial registrationNCT01779765

Highlights

The treatment of Irritable bowel syndrome (IBS) is still challenging
We assessed the short- and long–term effects of Partially hydrolyzed guar gum (PHGG) administration on clinical symptoms of IBS patients. This prospective randomized double blind placebocontrolled study was performed in the Clinical Nutrition Unit of Tel-Aviv Sourasky Medical Center (TASMC) in collaboration with the Departments of Gastroenterology in TASMC and in Sapir Medical Center, Israel
The PHGG group including 49 patients and the placebo group included 59 patients. The patients in both groups were of similar age (46.2±19.2 and 40.8±15.6 years for the PHGG and placebo groups, respectively, P = 0.1)

Summary

Introduction

The treatment of Irritable bowel syndrome (IBS) is still challenging. Hydrolyzed guar gum (PHGG) is a known prebiotic fiber. To assess the effects of PHGG on clinical symptoms of IBS patients in a prospective randomized double blind placebo-controlled study. Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder [1]. It is a benign, relapsing chronic disorder characterized by recurrent abdominal pain, bloating and altered bowel function. The main component of guar gum is galactomannan. It has been used in food processing as a thickener and emulsion stabilizer. Because guar gum is extremely viscous, it is very difficult to incorporate it in food in quantities large

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Conclusion