Does Partially Hydrolysed Guar Gum HAVE a Role to Play in the Treatment of Irritable Bowel Syndrome: A Systematic Review

Objective: Irritable bowel syndrome (IBS) is a functional bowel disorder characterised by abdominal discomfort or pain that is associated with a change in bowel habit. It is one of the most common gastrointestinal disorders worldwide. Management has thus far proven challenging. Partially hydrolysed guar gum (PHGG) is a soluble fibre that demonstrates beneficial microbiotamodifying properties. Preliminary research has shown promising effects of PHGG in the treatment of a number of gastrointestinal conditions, including IBS. The aim of this review was to systematically evaluate the efficacy of PHGG in the treatment of IBS.

Methods: A computer-based search of MEDLINE, EMBASE, and the Cochrane Library was conducted in June 2015. A hand-search of the bibliographies of relevant papers, previous reviews, and authors’ personal libraries was also undertaken. Trials were included in the review if they were human clinical trials (of any design) investigating the effects of PHGG on IBS-related symptoms or quality of life. There were no language restrictions. Eligibility assessment and data extraction were performed by two independent researchers.

Results: Nine trials were identified that met all eligibility criteria. Seven were open label trials and two were randomised, placebocontrolled trials. Heterogeniety in trial design and outcome precluded meta-analysis. All nine trials had results that were suggestive of the efficacy of PHGG.

Conclusions: PHGG shows promise in the treatment of IBS.A number of different mechanisms of action have been suggested, including modification of the gastrointestinal microbiota, normalisation of motility, and inhibition of substance P expression. Largescale, randomised, controlled trials appear warranted.