Current evidence on the therapeutic use of fiber in irritable bowel syndrome

Introduction: Patients with irritable bowel syndrome (IBS) frequently resort to natural products, or\r\nrequest doctors to prescribe them, to relieve their symptoms, due to the poor efficacy and tolerability of\r\nseveral traditional drugs. Products containing fiber are among the most used and their clinical efficacy\r\nis discussed here based on the most recent scientific evidence.\r\nAreas covered: A literature search was carried out to identify the most significant publications in order\r\nto deal with the topics of the general characteristics of fibers and the scientific evidence underlying\r\ntheir therapeutic use, the properties of ispaghula husk and the mechanisms by which this product\r\ncarries out its therapeutic actions.\r\nExpert opinion: The most recent clinical guidelines on the management of IBS consider ispaghula husk,\r\na product containing soluble fiber, as a reasonable first line therapy for IBS patients with symptoms. In\r\ncontrast, products containing insoluble fibers, particularly wheat bran, do not appear to be useful in\r\ntreating IBS symptoms. The clinical data on the use of prebiotics in IBS are still inconclusive. However,\r\nlow daily amounts of fructo-oligosaccharides or β-galacto-oligosaccharides (also known as trans-galacto\r\n-oligosaccharides) may be effective in improving IBS symptoms; further trials are needed to definitively\r\nestablish their clinical usefulness.