Dietary fiber in irritable bowel syndrome (Review)

Abstract

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. It is widely believed that IBS is caused by a deficient intake of dietary fiber, and most physicians recommend that patients with IBS increase their intake of dietary fiber in order to relieve their symptoms. However, different types of dietary fiber exhibit marked differences in physical and chemical properties, and the associated health benefits are specific for each fiber type. Short-chain soluble and highly fermentable dietary fiber, such as oligosaccharides results in rapid gas production that can cause abdominal pain/discomfort, abdominal bloating/distension and flatulence in patients with IBS. By contrast, long-chain, intermediate viscous, soluble and moderately fermentable dietary fiber, such as psyllium results in a low gas production and the absence of the symptoms related to excessive gas production. The effects of type of fiber have been documented in the management of IBS, and it is known to improve the overall symptoms in patients with IBS. Dietary fiber acts on the gastrointestinal tract through several mechanisms, including increased fecal mass with mechanical stimulation/irritation of the colonic mucosa with increasing secretion and peristalsis, and the actions of fermentation byproducts, particularly short-chain fatty acids, on the intestinal microbiota, immune system and the neuroendocrine system of the gastrointestinal tract. Fiber supplementation, particularly psyllium, is both safe and effective in improving IBS symptoms globally. Dietary fiber also has other health benefits, such as lowering blood cholesterol levels, improving glycemic control and body weight management.

Changes in the diet composition of fatty acids and fiber affect the lower gastrointestinal motility but have no impact on cardiovascular parameters: In vivo and in vitro studies

“…its mechanism of action is well described elsewhere. [10][11][12][13] In contrast, for many years, dietary fat has been studied in non-GI diseases, but only recently, the impact of FAs on GI function has become an attractive area of study to combat various GI-related disorders. [14][15][16][17] There are some clear signals that dietary FAs are relevant factors in the pathogenesis of GI disorders, 16,[18][19][20][21] but to our knowledge, most results were based on retrospective or prospective evaluation of dietary questionnaires, which raises the possibility of recall bias.…”

“…Fiber has long been recommended for the management of various gastrointestinal (GI) ailments, such as constipation or diarrhea; its mechanism of action is well described elsewhere . In contrast, for many years, dietary fat has been studied in non‐GI diseases, but only recently, the impact of FAs on GI function has become an attractive area of study to combat various GI‐related disorders .…”

Dietary therapies for functional bowel symptoms: Recent advances, challenges, and future directions

“…Similarly, many studies have investigated the role of increased or decreased intake of various forms of dietary fiber, but inconsistencies in the type of fiber used, or population studied makes formation of guidelines difficult . To date, the best evidence is for the use of psyllium fiber in IBS which has been reviewed elsewhere . Prebiotic fiber supplements provide promise due to their theoretical beneficial effect on the colonic microbiota, but overlap of some prebiotics with FODMAP composition (fructans and galacto‐oligoasaccharides) suggests some varieties may worsen symptoms of IBS .…”

“…41 To date, the best evidence is for the use of psyllium fiber in IBS which has been reviewed elsewhere. 29,42 Prebiotic fiber supplements provide promise due to their theoretical beneficial effect on the colonic microbiota, but overlap of some prebiotics with FODMAP composition (fructans and galacto-oligoasaccharides) suggests some varieties may worsen symptoms of IBS. 29 There is also potential for the use of strain-specific probiotics to target-specific symptom types, but current evidence is limited by lack of intentionto-treat analyses and inconsistencies in the types of single-or multistrain probiotic used.…”

Корекція Кишкової Мікробіоти В Лікуванні Синдрому Подразненого Кишечника В Дітей

“…А вот длинно-цепочечное, растворимое и умеренно ферменти-руемое пищевое волокно Psyllium (подорожник блошный) способствует снижению выработки газа в кишечнике. Позитивный эффект пищевых волокон Psyllium на клиническую симптоматику СРК реализуется еще несколькими механизмами: увеличение объема фекальной массы способству-ет механической стимуляции слизистой оболочки толстой кишки и увеличению перистальтики; дей-ствие побочных продуктов ферментации, особен-но короткоцепочечных жирных кислот, на кишеч-ную микробиоту, иммунную и нейроэндокринную системы желудочно-кишечного тракта [48]. Аме-риканские гастроэнтерологи в РКИ с участием 103 детей с СРК изучали влияние волокон Psyllium (подорожника) на клиническое течение заболева-ния.…”