Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial Robert J. Shulman, Emily B. Hollister,

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Presentation transcript:

Psyllium Fiber Reduces Abdominal Pain in Children With Irritable Bowel Syndrome in a Randomized, Double-Blind Trial Robert J. Shulman, Emily B. Hollister, Kevin Cain, Danita I. Czyzewski, Mariella M. Self, Erica M. Weidler, Sridevi Devaraj, Ruth Ann Luna, James Versalovic, Margaret Heitkemper Clinical Gastroenterology and Hepatology Volume 15, Issue 5, Pages 712-719.e4 (May 2017) DOI: 10.1016/j.cgh.2016.03.045 Copyright © 2017 AGA Institute Terms and Conditions

Figure 1 Abdominal pain symptoms. The reduction in (A) pain frequency but not (B) severity was significantly different between groups. The same Figure legends are used for Figures 2-4. Clinical Gastroenterology and Hepatology 2017 15, 712-719.e4DOI: (10.1016/j.cgh.2016.03.045) Copyright © 2017 AGA Institute Terms and Conditions

Figure 2 Stool characteristics. (A) Percent of stools that were classified as normal did not differ between groups. (B) There were a lower percentage of stools classified as constipation in the placebo group. (C) There was a trend for a lower percentage of stools to be classified as diarrhea in the fiber group. Clinical Gastroenterology and Hepatology 2017 15, 712-719.e4DOI: (10.1016/j.cgh.2016.03.045) Copyright © 2017 AGA Institute Terms and Conditions

Figure 3 Breath hydrogen and methane production. There were no differences between groups in (A) hydrogen or (B) methane area under the curve. Clinical Gastroenterology and Hepatology 2017 15, 712-719.e4DOI: (10.1016/j.cgh.2016.03.045) Copyright © 2017 AGA Institute Terms and Conditions

Figure 4 Gut permeability. (A) The percent sucrose recovery was similar between groups. (B) The lactulose/mannitol ratio was similar between groups. (C) The percent sucralose recovery was similar between groups. Clinical Gastroenterology and Hepatology 2017 15, 712-719.e4DOI: (10.1016/j.cgh.2016.03.045) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 1 Study design. Clinical Gastroenterology and Hepatology 2017 15, 712-719.e4DOI: (10.1016/j.cgh.2016.03.045) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 2 Consort diagram. The majority of children who dropped out did so before starting treatment. Clinical Gastroenterology and Hepatology 2017 15, 712-719.e4DOI: (10.1016/j.cgh.2016.03.045) Copyright © 2017 AGA Institute Terms and Conditions

Supplementary Figure 3 Stool microbiome composition. There was a trend at baseline toward (A) increased Bacteroidetes and decreased Firmicutes in the fiber group, and a similar trend at the (B) class level with Bacteroidia, whereas the (C) placebo group was marginally enriched in Clostridia. Clinical Gastroenterology and Hepatology 2017 15, 712-719.e4DOI: (10.1016/j.cgh.2016.03.045) Copyright © 2017 AGA Institute Terms and Conditions