Evidence map›Paper›PMID 19713235›Full record

Trial reportBMJ (Clinical research ed.)2009

Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial.

C J Bijkerk, N J de Wit, J W M Muris, P J Whorwell, J A Knottnerus, A W Hoes

Registry-linked trialOpen access · hybridAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00189033 (Dietary Interventions in Irritable Bowel Syndrome), which is not on this map. Cited by 89 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
89citing papers in PubMed, 9 pooled it
15.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00189033 nacompletednot on this map

Dietary Interventions in Irritable Bowel Syndrome: Soluble, Insoluble or no Fibre? A Randomized Controlled Trial in Primary Care.

TypeinterventionalSponsorUMC UtrechtRan2005 to 2007Enrolled285ConditionsColonic Diseases, FunctionalArmspsyllium fibre (dietary supplement), wheat bran (dietary supplement), rice wheat (placebo)
3 · Its place in the literature

Who cites it

89 citing papers in PubMed, 9 syntheses or guidelines pooled it, 303 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
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  6. Pooled it
  7. Pooled it
  8. Irritable bowel syndrome.BMJ clinical evidence · 2012
    Pooled it
  9. Pooled it
  10. Trial
  11. Trial
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  14. Does a self-management program change dietary intake in adults with irritable bowel syndrome?Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates
    Trial
  15. Article
  16. Review
  17. Review
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  19. Review
  20. Review

29 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

C J BijkerkJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, Netherlands. c.j.bijkerk-2@umcutrecht.nl
N J de Wit
J W M Muris
P J Whorwell
J A Knottnerus
A W Hoes
University Medical Center Utrecht · NLMaastricht University · NLUniversity of Manchester · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the effectiveness of increasing the dietary content of soluble fibre (psyllium) or insoluble fibre (bran) in patients with irritable bowel syndrome.

designRandomised controlled trial.

settingGeneral practice.

participants275 patients aged 18-65 years with irritable bowel syndrome.

interventions12 weeks of treatment with 10 g psyllium (n=85), 10 g bran (n=97), or 10 g placebo (rice flour) (n=93).

main outcome measuresThe primary end point was adequate symptom relief during at least two weeks in the previous month, analysed after one, two, and three months of treatment to assess both short term and sustained effectiveness. Secondary end points included irritable bowel syndrome symptom severity score, severity of abdominal pain, and irritable bowel syndrome quality of life scale.

resultsThe proportion of responders was significantly greater in the psyllium group than in the placebo group during the first month (57% v 35%; relative risk 1.60, 95% confidence interval 1.13 to 2.26) and the second month of treatment (59% v 41%; 1.44, 1.02 to 2.06). Bran was more effective than placebo during the third month of treatment only (57% v 32%; 1.70, 1.12 to 2.57), but this was not statistically significant in the worst case analysis (1.45, 0.97 to 2.16). After three months of treatment, symptom severity in the psyllium group was reduced by 90 points, compared with 49 points in the placebo group (P=0.03) and 58 points in the bran group (P=0.61 versus placebo). No differences were found with respect to quality of life. Fifty four (64%) of the patients allocated to psyllium, 54 (56%) in the bran group, and 56 (60%) in the placebo group completed the three month treatment period. Early dropout was most common in the bran group; the main reason was that the symptoms of irritable bowel syndrome worsened.

conclusionsPsyllium offers benefits in patients with irritable bowel syndrome in primary care.

trial registrationClinical trials NCT00189033.

Indexed as

PlantagoAbdominal PainAdolescentAdultAgedDietary FiberFamily PracticeFemaleHumansIrritable Bowel SyndromeMaleMiddle AgedTreatment OutcomeYoung AdultDietary Fiber

Identifiers

PMID19713235
PMCPMC3272664
OpenAlexW2052159025

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.