Psyllium reduces inulin-induced colonic gas production in IBS: MRI and in vitro fermentation studies.
Psyllium reduces inulin-induced colonic gas production in IBS: MRI and in vitro fermentation studies.
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DOI：
10.1136/gutjnl-2021-324784
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发表时间：
2022-05
期刊：
影响因子：
24.5
通讯作者：
Spiller RC
中科院分区：
文献类型：
--
作者：
Gunn D;Abbas Z;Harris HC;Major G;Hoad C;Gowland P;Marciani L;Gill SK;Warren FJ;Rossi M;Remes-Troche JM;Whelan K;Spiller RC
包括菊粉在内的促进健康的膳食纤维经常会引发IBS患者的胃肠道症状，限制他们的摄入量。我们的目的是测试联合使用木耳和菊粉是否会减少产气量。在19名IBS患者中进行的一项随机、四个周期、四个治疗、安慰剂对照的交叉试验。受试者饮用500 毫升的试验饮料，其中包括菊粉20 g、木瓜20 g、菊粉20 g+木豆20 g或葡萄糖20 g(安慰剂)。每30 分钟测量一次呼气氢，每小时进行一次磁共振扫描，连续6小时。来自IBS患者子组的粪便样本使用体外发酵模型进行了测试。主要终点是由MRI评估的结肠气体。结肠气体在0~6 小时内稳步升高，菊粉升高幅度最大，中位数(IQR)AUC(0~360min)3145(848~6502) mL.菊粉和木耳联合给药显著降低至618(62-2345) 毫升·分钟(p=0.02)，与安慰剂无显著差异。无论是菊粉(p=0.002)还是菊粉和木瓜联合给药(p=0.005)，结肠容量AUC(0-360min)均显著大于安慰剂。呼气氢从菊粉后120ppm in显著升高，但木耳无明显变化，木耳与菊粉合用延缓并降低最大升幅，AUC0~360min由7230(3255~17910) ·h降至1035(360~4320)ppm·h，p=0.007。在体外发酵中，菊粉比木耳产生更多的气体。木耳和菊粉的结合并没有减少产气量。木耳减少IBS患者菊粉相关气体的产生，但不直接抑制发酵。与木耳联合给药是否增加了IBS患者对益生素的耐受性，值得进一步研究。NCT03265002。
Health-promoting dietary fibre including inulin often triggers gastrointestinal symptoms in patients with IBS, limiting their intake. Our aim was to test if coadministering psyllium with inulin would reduce gas production. A randomised, four-period, four-treatment, placebo-controlled, crossover trial in 19 patients with IBS. Subjects ingested a 500 mL test drink containing either inulin 20 g, psyllium 20 g, inulin 20 g+ psyllium 20 g or dextrose 20 g (placebo). Breath hydrogen was measured every 30 min with MRI scans hourly for 6 hours. Faecal samples from a subset of the patients with IBS were tested using an in vitro fermentation model. Primary endpoint was colonic gas assessed by MRI. Colonic gas rose steadily from 0 to 6 hours, with inulin causing the greatest rise, median (IQR) AUC(0–360 min) 3145 (848–6502) mL·min. This was significantly reduced with inulin and psyllium coadministration to 618 (62–2345) mL·min (p=0.02), not significantly different from placebo. Colonic volumes AUC(0–360 min) were significantly larger than placebo for both inulin (p=0.002) and inulin and psyllium coadministration (p=0.005). Breath hydrogen rose significantly from 120 min after inulin but not psyllium; coadministration of psyllium with inulin delayed and reduced the maximum increase, AUC(0–360 min) from 7230 (3255–17910) ppm·hour to 1035 (360–4320) ppm·hour, p=0.007. Fermentation in vitro produced more gas with inulin than psyllium. Combining psyllium with inulin did not reduce gas production. Psyllium reduced inulin-related gas production in patients with IBS but does not directly inhibit fermentation. Whether coadministration with psyllium increases the tolerability of prebiotics in IBS warrants further study. NCT03265002.
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影响因子：
3.6
作者：
Hooda, Seema;Metzler-Zebeli, Barbara U.;Zijlstra, Ruurd T.
通讯作者：
Zijlstra, Ruurd T.
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