17 June 2009

Fiber for IBS, which is best?

Patients with irritable bowel syndrome (IBS) could find great relief from using dietary fiber, but how can clinicians make sure they get the right fiber?

A 2004 systemic review published in Ailment Pharmacol Ther improved means of advising patients with IBS on which fiber to take. The review included 17 randomized, controlled trials on both soluble (psyillium, ispaghula, calcium polycarbophil) and insoluble fiber sources (corn and wheat bran) (1). The researchers found that the soluble fiber sources were effective in providing relief to patients while insoluble fiber sources worsened symptoms in a few cases (1).

Based on these important findings, the Harvard University Medical School advised that soluble sources of fiber “are more effective” than that of insoluble for IBS in “alleviating global symptoms and relieving constipation, although fiber in general has marginal benefit” (2).

Reference List

1. 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;19:245-51.
2. Chang HY, Kelly EC, Lembo AJ. Current gut-directed therapies for irritable bowel syndrome. Curr Treat Options Gastroenterol 2006;9:314-23.

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