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Review: fibre, antispasmodics, and peppermint oil are all effective for irritable bowel syndrome

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In patients with irritable bowel syndrome (IBS), what is the effectiveness of fibre, antispasmodics, and peppermint oil?


Included studies were randomised controlled trials (RCTs) that compared fibre, antispasmodics, or peppermint oil with placebo or no treatment in adults (>16 y of age) who had IBS (diagnosed by clinician or met specific criteria) and were followed up for ⩾1 week. Outcomes were global symptoms of IBS or abdominal pain after treatment and adverse events.


Medline and EMBASE/Excerpta Medica (to Apr 2008), and Cochrane Controlled Trials Register (2007) were searched for RCTs. Abstract books of conference proceedings (2001–7) and reference lists were hand searched. 35 RCTs were included. Jadad scores for study quality ranged from 1 to 5 (mean 3.8 out of 5).


Fibre: 12 RCTs (n = 591) compared fibre with placebo (11 RCTs) or a low-fibre diet (1 RCT). 5 RCTs used bran, 6 used ispaghula …

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  • Source of funding: American College of Gastroenterology.