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Evidence summaries

Dietary Fibre in the Treatment of Irritable Bowel Syndrome

Soluble fibre improves overall symptoms and constipation but not abdominal pain in irritable bowel syndrome. Level of evidence: "A"

A systematic review 1 included 17 studies with a total of 1 363 subjects with irritable bowel syndrome (IBS). Fibre, in general, was effective in the relief of global IBS symptoms (RR 1.33; 95% CI 1.19-1.50). IBS patients with constipation may receive benefit from fibre treatment (RR 1.56; 95% CI 1.21-2.02), but there was no evidence that fibre was effective in the relief of abdominal pain in irritable bowel syndrome. Soluble fibre (psyllium, ispaghula, calcium polycarbophil; 9 studies) showed significant improvement (RR 1.55; 95% CI 1.35-1.78), whereas insoluble fibre (corn, wheat, bran; 8 studies), in some cases, worsened the clinical outcome, but there was no significant difference compared with placebo (RR 0.89; 95% CI 0.72-1.11).

    References

    • Bijkerk CJ, Muris JW, Knottnerus JA, Hoes AW, de Wit NJ. Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther 2004 Feb 1;19(3):245-51. [PubMed]

Primary/Secondary Keywords