Nopal fiber (Opuntia ficus‐indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial

Abstract

Background Clinical guidelines provide limited and conflicting recommendations regarding dietary fiber supplementation in irritable bowel syndrome (IBS). Nopal (Opuntia ficus‐indica) is a cactus plant fiber containing both insoluble and soluble fibers that may have therapeutic potential in IBS. Our aim was to evaluate the dose–response effect of extracted nopal fiber powder on symptoms in IBS. Methods We performed a 4‐arm, double‐blind, parallel, randomized controlled trial in 60 patients fulfilling Rome IV criteria for IBS. Patients were randomized and blindly allocated to receive either nopal fiber (10, 20, or 30 g/day) or placebo (30 g/day dextrose) for one week and to keep their usual diet. Symptom severity (Global Symptom Question, IBS‐SSS, Gastrointestinal Symptom Rating Scale), stool frequency and consistency (Bristol Stool Form Scale), breath hydrogen response, and stool short‐chain fatty acids (SCFA) were measured at baseline and follow‐up. Key results Significantly more patients reported adequate relief of symptoms after 20 g/day (87%, p = 0.008) and 30 g/day (80%, p = 0.025) of nopal fiber compared to placebo (33%). More patients receiving 20 g/day nopal fiber (67%) had a > 50% reduction in IBS‐SSS compared to placebo (20%, p = 0.027), whereas the 30 g/day dose induced more loose stools (p = 0.027). Response rates were similar among IBS subtypes. There were no differences in breath hydrogen or stool SCFA between groups. Conclusions and inferences Nopal fiber supplementation at doses of 20 and 30 g/day was associated with short‐term improvement in IBS symptoms, warranting a fully powered clinical trial of longer duration with symptomatic, physiological, and microbiological endpoints.

Pasta Supplemented with Opuntia ficus-indica Extract Improves Metabolic Parameters and Reduces Atherogenic Small Dense Low-Density Lipoproteins in Patients with Risk Factors for the Metabolic Syndrome: A Four-Week Intervention Study

“…In recent years, there has been increased clinical need for, and strong research efforts focused on, natural approaches to MetS management [78,79] and even food supplementation with OFI [80][81][82][83]. Although our study was relatively small and limited in drawing any definitive inferences, especially in view of inter-/intra-individual variability, the preliminary data presented herein is highly suggestive of a potential beneficial protective activity of OFI extract on CVD based on its effects on both lipid and glucose metabolism.…”

A standardized extract ofOpuntia ficus‐indica(L.) Mill andOlea europaeaL. improves gastrointestinal discomfort: Adouble‐blinded randomized‐controlledstudy

“…O. ficus-indica, a plant belonging to the Cactaceae family, has been largely used for its health-promoting properties for thousands of years (Remes-Troche et al, 2020). The literature data highlight that its antiulcerogenic and gastroprotective activities may have possible beneficial effects on GD (Galati et al, 2003;Galati, Pergolizzi, Miceli, Monforte, & Tripodo, 2002).…”

“…Many plants with beneficial properties are used in traditional medicine for the managing of GDs, treating symptoms like abdominal pain, heartburn, constipation, flatulence, and so on (Thumann, Pferschy‐Wenzig, Moissl‐Eichinger, & Bauer, 2019). O. ficus‐indica , a plant belonging to the Cactaceae family, has been largely used for its health‐promoting properties for thousands of years (Remes‐Troche et al, 2020). The literature data highlight that its antiulcerogenic and gastroprotective activities may have possible beneficial effects on GD (Galati et al, 2003; Galati, Pergolizzi, Miceli, Monforte, & Tripodo, 2002).…”

“…Recently Aboura and collaborators showed that Ceratonia siliqua leaf and O. ficus‐indica cladode extracts could mitigate inflammation severity associated with obesity and colitis, through the modulation of pro‐inflammatory cytokine and targeting NF‐κβ pathway, in an in vivo model of diet‐induced obesity (Aboura et al, 2017). A randomized controlled trial showed that supplementation with fibers from O. ficus‐indica at a dose of 20 g is associated with a relevant improvement in irritable bowel syndrome symptoms (Remes‐Troche et al, 2020). Fibers, O. ficus‐indica is rich in dietary fibers both soluble and insoluble, are well‐known to increase the water content so ameliorating fecal bulk and the gastrointestinal transit and also is demonstrated that exert a beneficial impact on the gut microbiome (Zhang et al, 2020).…”

“…* = p < .01 vs. placebo [Colour figure can be viewed at wileyonlinelibrary.com] model of diet-induced obesity(Aboura et al, 2017). A randomized controlled trial showed that supplementation with fibers from O. ficus-indica at a dose of 20 g is associated with a relevant improvement in irritable bowel syndrome symptoms(Remes- Troche et al, 2020). Fibers, O. ficus-indica is rich in dietary fibers both soluble and insoluble, are well-known to increase the water content so ameliorating fecal bulk and the gastrointestinal transit…”