The problem of insoluble fibre in irritable bowel syndrome

doi:10.1136/bmj.a3149

Published 6 January 2009, doi:10.1136/bmj.a3149
Cite this as: BMJ 2009;338:a3149

Letters

Irritable bowel syndrome

The problem of insoluble fibre in irritable bowel syndrome

The first 150 words of the full text of this article appear below.

I was surprised to read in the popular press that, accordingto the BMJ,¹ fibre is good for irritable bowel syndrome.

In 1994 we suggested that, at least in secondary care, cerealfibre was more likely to do harm than good in patients withirritable bowel syndrome.² Now, as a gastroenterologist probablyseeing more cases of severe irritable bowel than most of mycolleagues, I find that the total exclusion of all cereal fibre,such as bran and brown bread, from the diet is one of the mostrewarding treatment strategies I can offer.

Ford and colleagues acknowledge that bran (insoluble fibre)as opposed to ispaghula (soluble fibre) is not effective inirritable bowel syndrome but claim that it does not exacerbatesymptoms,¹ presumably because of the lack of side effects reportedin the trials they reviewed. However, trials of fibre have traditionallylooked for improvement or no improvement . . . [Full text of this article]

Peter J Whorwell, professor of medicine and gastroenterology¹

¹ Wythenshawe Hospital, Manchester M23 9LT

peter.whorwell@uhsm.nhs.uk

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis: Alexander C Ford, Nicholas J Talley, Brennan M R Spiegel, Amy E Foxx-Orenstein, Lawrence Schiller, Eamonn M M Quigley, and Paul Moayyedi
BMJ 2008 337: a2313. [Abstract] [Full Text] [PDF]