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

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

Efficacy and Safety of Probiotics, Prebiotics and Synbiotics in the Treatment of Irritable Bowel Syndrome: A systematic review and meta-analysis

“…[32][33][34][40][41][42][43][44][45][46][47][48][49] The rest of the trials utilised the Rome III criteria. [26][27][28][29][30][31][35][36][37][38][39][50][51][52][53][54][55][56][57][58] In terms of intervention, three trials investigated prebiotics (partially-hydrolysed guar gum and fructooligosaccharides) and three investigated synbiotics. 38,40,42,50,51 The remaining 27 RCTs evaluated probiotics.…”

“…[26][27][28][29][30][31][35][36][37][38][39][50][51][52][53][54][55][56][57][58] In terms of intervention, three trials investigated prebiotics (partially-hydrolysed guar gum and fructooligosaccharides) and three investigated synbiotics. 38,40,42,50,51 The remaining 27 RCTs evaluated probiotics. [26][27][28][29][30][31][32][33][34][35][36][37]39,41,43,44,[46][47][48][49][52][53][54][55][56][57]…”

The Evolving Role of Gut Microbiota in the Management of Irritable Bowel Syndrome: An Overview of the Current Knowledge

“…Interestingly, the prebiotic but not the placebo significantly enhanced fecal bifidobacteria [71]. A 12-week administration of partially hydrolyzed guar gum in a randomized, double-blind, placebo-controlled study led to a significant improvement in bloating and gasses scores with no effect on other reported IBS symptoms or quality of life scores, leading the authors to support its administration for IBS patients with an expected clinical effect on bloating and gasses [72]. In safety terms, all studies reported comparable rates of adverse events to the placebo arms.…”

Study on the ability of partially hydrolyzed guar gum to modulate the gut microbiota and relieve constipation

“…PHGG is generally recognized as safe and has been reported to reduce symptoms of IBS (Niv et al, 2016), improve glycemic control (Goulder, Alberti, & Jenkins, 1978), and relieve diarrhea (Spapen et al, 2001). Moreover, PHGG has also been studied in constipated subjects, and has been shown to reduce the fecal pH and increase defecation frequency and fecal moisture (Hidehisa et al, 1994).…”