Ispaghula therapy in irritable bowel syndrome: Improvement in overall well‐being is related to reduction in bowel dissatisfaction

Jalihal, Anand; Kurian, George

doi:10.1111/j.1440-1746.1990.tb01432.x

Cited by 48 publications

(27 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There have been a number of trials of either fiber supplementation or bulking agents for IBS 22,28,30,[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] (Table 2). Most of these trials were done between 1976 and 1994.…”

Section: Fiber Trialsmentioning

confidence: 99%

The Role of Fiber in the Treatment of Irritable Bowel Syndrome

Zuckerman¹

2006

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

Irritable bowel syndrome is a common clinical condition that often presents a therapeutic challenge. There is no standard therapy and a multilevel approach is recommended. A high-fiber diet is often one of these components. Many investigators have studied the effectiveness of either fiber supplementation or bulking agents in patients with irritable bowel syndrome. The purpose of this review is to summarize the current literature on the use of fiber in irritable bowel syndrome and to provide some specific recommendations. Systematic reviews of these trials have generally not found fiber to be significantly more effective than placebo at relieving global irritable bowel syndrome symptoms. There may be differences between results obtained with soluble and insoluble fiber. Adverse effects of fiber use may include abdominal discomfort and bloating. Although dietary fiber or bulking agents do not appear to be useful as sole treatment of irritable bowel syndrome, they may have a limited role in empiric therapy depending upon the patient's symptom complex, especially if constipation is the most significant symptom. The basic principles for using fiber therapy are to start with a low dose and increase slowly, to give an adequate trial and to evaluate the results early and periodically.

show abstract

Section: Fiber Trialsmentioning

confidence: 99%

The Role of Fiber in the Treatment of Irritable Bowel Syndrome

Zuckerman¹

2006

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

show abstract

“…The episperm and collapsed layers from the seeds of Plantago ovata , the ispaghula seed husk, may be used instead in a dose of 4 to 20 g per day [26]. In a dose-finding study [27], 20 g ispaghula seed husk was identified as possibly optimum daily dosage for treating IBS complaints. Lower doses were less effective.…”

Section: Discussionmentioning

confidence: 99%

Best Available Evidence in Cochrane Reviews on Herbal Medicine?

Davidson

Vlachojannis

Cameron

et al. 2013

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

Cochrane reviews are considered by many to be the “gold standard” or the final word in medical conversation on a topic. We explored the eleven most relevant Cochrane reviews on herbal medicine and identified that frequently herbal medicines in the included studies had not been sufficiently well characterised. If data on the effects of the plant parts are unavailable, effects of co-active ingredients need to be considered and the plausibility of the study medications for the specific indications discussed. Effect sizes calculated from exploratory studies would be best used to determine the sample sizes required for future confirmatory studies, rather than as definitive reports of intervention effects. Reviews should be comprehensive, including discussion of putative adverse events and possible drug interactions. We suggest that the guidelines for preparing Cochrane reviews be revised and offer assistance in this task.

show abstract

“…At 10 g twice daily, bran was found to improve IBS symptoms, but the onset of efficacy was delayed until month 3 of treatment [14]. In clinical trials, psyllium and bran were well tolerated when initiated at the aforementioned maintenance doses, suggesting titration may not be necessary [13,14,15,16,17,18]; however, clinical experience with poor patient tolerance when no titration was performed suggests titration is important with fiber supplementation. Similarly, although adverse effects were found to be similar to placebo in clinical trials, patients were still at risk for adverse effects observed in persons without IBS, including abdominal pain, constipation, nausea, flatulence, and diarrhea.…”

Section: Resultsmentioning

confidence: 99%

“…Efficacious doses of psyllium ranged from 3 g twice daily to 6.4 g three times daily to 30 g once daily. Onset of efficacy with psyllium has occurred within 4 weeks of use [13,14]. At 10 g twice daily, bran was found to improve IBS symptoms, but the onset of efficacy was delayed until month 3 of treatment [14].…”

Section: Resultsmentioning

confidence: 99%

Medication Management of Irritable Bowel Syndrome

Trinkley

Nahata²

2014

Digestion

View full text Add to dashboard Cite

Background: Irritable bowel syndrome (IBS) is a complex syndrome that is difficult to manage. Here we present the evidence supporting medication treatments for specific IBS symptoms, discuss evidence-based management of IBS with medications including dose regimens and adverse effects and review progress on research for new IBS treatments. Summary: Currently, there is evidence to support improvements in specific IBS symptoms following treatment with loperamide, psyllium, bran, lubiprostone, linaclotide, amitriptyline, trimipramine, desipramine, citalopram, fluoxetine, paroxetine, dicyclomine, peppermint oil, rifaximin, ketotifen, pregabalin, gabapentin and octreotide and there are many new medications being investigated for the treatment of IBS. Key Message: Of the medications with demonstrated improvements for IBS symptoms, rifaximin, lubiprostone, linaclotide, fiber supplementation and peppermint oil have the most reliable evidence supporting their use for the treatment of IBS. Onset of efficacy for the various medications has been noted to be as early as 6 days after initiation; however, the efficacy of most medications was not assessed prospectively at predefined periods. Additional studies of currently available and new medications are ongoing and are needed to better define their place in therapy and expand therapeutic options for the treatment of IBS. The most promising new medications for IBS include a variety of novel pharmacologic approaches, most notably the dual μ-opioid receptor agonist and δ-opioid antagonist, JNJ-27018966.

show abstract

Ispaghula therapy in irritable bowel syndrome: Improvement in overall well‐being is related to reduction in bowel dissatisfaction

Cited by 48 publications

References 18 publications

The Role of Fiber in the Treatment of Irritable Bowel Syndrome

The Role of Fiber in the Treatment of Irritable Bowel Syndrome

Best Available Evidence in Cochrane Reviews on Herbal Medicine?

Medication Management of Irritable Bowel Syndrome

Contact Info

Product

Resources

About