Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Fiber supplementation is scientifically validated as a supportive treatment for Irritable Bowel Syndrome (IBS), though the type of fiber used is important. Multiple randomized controlled trials and meta-analyses have demonstrated that certain fibers, especially soluble fibers such as psyllium (ispaghula husk), can improve IBS symptoms, particularly constipation and overall bowel function. The proposed mechanisms include increased stool bulk, modulation of gut microbiota, and improved colonic transit time. Insoluble fibers (like wheat bran), however, have shown less benefit and may even exacerbate symptoms in some patients.

A 2014 Cochrane review and a 2020 meta-analysis both concluded that soluble fiber supplementation leads to overall symptom improvement in IBS, with moderate to high quality evidence. Guidelines from the American College of Gastroenterology and the National Institute for Health and Care Excellence (NICE) recommend the use of specific soluble fibers for IBS. However, the response is variable and some individuals may experience bloating or discomfort, especially when starting fiber supplementation or using insoluble fibers.

In summary, there is robust scientific evidence supporting the use of certain types of fiber, particularly soluble fiber, as part of the management strategy for IBS. The choice and introduction of fiber should be individualized based on patient tolerance and symptom profile.

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