Published 29 September 2009, doi:10.1136/bmj.b3956
Cite this as: BMJ 2009;339:b3956

Letters

Bran and irritable bowels

Bran’s deleterious effects: much ado about nothing

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

Bijkerk and colleagues’ randomised controlled trial of soluble and insoluble fibre supplementation in irritable bowel syndrome is the first to be conducted entirely in primary care.¹

In a systematic review and meta-analysis of trials in specialist settings, our group reported a beneficial effect of soluble fibre in the form of psyllium (or ispaghula husk) in irritable bowel syndrome with a number needed to treat (NNT) of 6 (95% confidence interval 3 to 50).² Insoluble fibre in the form of bran was of no benefit, though we could not examine any potentially deleterious effect on symptoms suggested by some investigators³ because of the way in which data were reported. In Bijkerk and colleagues’ trial, the high drop-out rates at 12 weeks meant that the effects of ispaghula on abdominal pain or discomfort were only modest, but when these data were incorporated into our meta-analysis the NNT was similar (7 (4 to . . . [Full text of this article]

¹ Department of Academic Medicine, St James’s University Hospital, Leeds LS9 7TF, ² Gastroenterology Division, McMaster University, Health Sciences Centre, Hamilton, ON, Canada L8N 3Z5

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