The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis.

Paul Moayyedi, Eamonn M M Quigley, Brian E. Lacy, Anthony J. Lembo, Yuri Ann Saito Loftus, Lawrence R. Schiller, Edy E. Soffer, Brennan M R Spiegel, Alexander C. Ford

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Abstract

Fiber has been used for many years to treat irritable bowel syndrome (IBS). This approach had fallen out of favor until a recent resurgence, which was based on new randomized controlled trial (RCT) data that suggested it might be effective. We have previously conducted a systematic review of fiber in IBS, but new RCT data for fiber therapy necessitate a new analysis; thus, we have conducted a systematic review of this intervention. MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched up to December 2013. Trials recruiting adults with IBS, which compared fiber supplements with placebo, control therapy, or "usual management", were eligible. Dichotomous symptom data were pooled to obtain a relative risk (RR) of remaining symptomatic after therapy as well as number needed to treat (NNT) with a 95% confidence interval (CI). We identified 14 RCTs involving 906 patients that had evaluated fiber in IBS. There was a significant benefit of fiber in IBS (RR=0.86; 95% CI 0.80-0.94 with an NNT=10; 95% CI=6-33). There was no significant heterogeneity between results (I(2)=0%, Cochran Q=13.85 (d.f.=14), P=0.46). The benefit was only seen in RCTs on soluble fiber (RR=0.83; 95% CI 0.73-0.94 with an NNT=7; 95% CI 4-25) with no effect seen with bran (RR=0.90; 95% CI 0.79-1.03). Soluble fiber is effective in treating IBS. Bran did not appear to be of benefit, although we did not uncover any evidence of harm from this intervention, as others have speculated from uncontrolled data.

Original languageEnglish (US)
Pages (from-to)1367-1374
Number of pages8
JournalThe American journal of gastroenterology
Volume109
Issue number9
DOIs
StatePublished - 2014

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Irritable Bowel Syndrome
Meta-Analysis
Confidence Intervals
Numbers Needed To Treat
Randomized Controlled Trials
MEDLINE
Therapeutics
Placebos

ASJC Scopus subject areas

  • Medicine(all)

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The effect of fiber supplementation on irritable bowel syndrome : a systematic review and meta-analysis. / Moayyedi, Paul; Quigley, Eamonn M M; Lacy, Brian E.; Lembo, Anthony J.; Saito Loftus, Yuri Ann; Schiller, Lawrence R.; Soffer, Edy E.; Spiegel, Brennan M R; Ford, Alexander C.

In: The American journal of gastroenterology, Vol. 109, No. 9, 2014, p. 1367-1374.

Research output: Contribution to journalArticle

Moayyedi, P, Quigley, EMM, Lacy, BE, Lembo, AJ, Saito Loftus, YA, Schiller, LR, Soffer, EE, Spiegel, BMR & Ford, AC 2014, 'The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis.', The American journal of gastroenterology, vol. 109, no. 9, pp. 1367-1374. https://doi.org/10.1038/ajg.2014.195
Moayyedi, Paul ; Quigley, Eamonn M M ; Lacy, Brian E. ; Lembo, Anthony J. ; Saito Loftus, Yuri Ann ; Schiller, Lawrence R. ; Soffer, Edy E. ; Spiegel, Brennan M R ; Ford, Alexander C. / The effect of fiber supplementation on irritable bowel syndrome : a systematic review and meta-analysis. In: The American journal of gastroenterology. 2014 ; Vol. 109, No. 9. pp. 1367-1374.
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