Guar gum alleviates IBS-related constipation in a randomised controlled trial

Partially hydrolysed guar gum (PHGG), a water-soluble fibre, appeared efficacious in participants with irritable bowel syndrome (IBS)-associated chronic constipation. Moreover, PHGG displayed an excellent safety profile.

“Current guidelines recommend fibre supplements as a frontline therapy for constipation, especially for individuals who do not meet the recommended daily fibre intake,” explained Dr Silvia Delgado-Aros (Nestle Health Sciences, Switzerland) [1]. “Although placebo-controlled trials show moderate evidence for the use of soluble fibres in constipation, patients with IBS-associated constipation often have a poor tolerance to these substances.” PHGG is a non-absorbable, water-soluble vegetable fibre that may be better tolerated among these patients.

A double-blind, randomised controlled trial compared the efficacy and safety of PHGG with placebo in adults with functional or IBS-associated chronic constipation. The participants (n=160) received 10 g of PHGG daily or a placebo. The primary endpoint was the frequency of spontaneous bowel movements per week after 6 weeks of therapy.

At week 6, participants in the active arm had a mean increase of 1.57 spontaneous bowel movements per week, compared with 1.14 in the placebo arm (P=0.034), meeting the primary endpoint. The responders' rate, defined as participants who had at least 3 spontaneous bowel movements per week and had an increase of at least 1 over the study period, was also higher in the active arm than in the placebo arm (34.2% vs 17.7%; P=0.018). “In practical terms, the number needed to treat in the active arm was 6,” according to Dr Delgado-Aros.

No serious adverse events (AEs) or discontinuations due to AEs were reported. The AE rates were comparable in the placebo and active arms, with 37.5% and 42.5% of the participants experiencing at least 1 AE, respectively.

“The non-absorbable water-soluble fibre PHGG seems to have a place in the fibre recommendation space for patients with functional or IBS-associated chronic constipation,” concluded Dr Delgado-Aros.

1. 
   
   1. Buckley MJ, et al. RCT assessing effect of 6-week intervention with 10gr daily dose of partially hydrolyzed guar gum (PHGG) on spontaneous bowel movement frequency in adults with chronic constipation. LB12, UEG Week 2024, 12–15 October, Vienna, Austria.

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Posted on 28 November 2024