Psyllium Husk Effective for Pediatric Irritable Bowel Therapy in Short Term Compared to Placebo

by | Mar 1, 2023 | 2023, Digestive Health, Fiber, Infant and Children's Health, Irritable Bowel Syndrome, Probiotics

Written by Taylor Woosley, Staff Writer. 4-week administration of psyllium husk resulted in a significant reduction of IBS-SSS and 43.9% entered remission compared to 9.7% achieving remission in the placebo group. 

Irritable bowel syndrome (IBS) is a common disorder in children with an increasing prevalence noted during the past two decades1. It is a functional gastrointestinal disorder characterized by varying degrees of abdominal pain or discomfort, abdominal distension, altered bowel habits, and flatulence2. Adolescents with chronic pain, including those with IBS, report poor social functioning, fewer friends, and more peer victimization and isolation compared with children without chronic pain3.

Diet and nutrition are known to play key roles in many chronic gastrointestinal diseases, regarding therapeutic possibilities4. Psyllium husk can be considered to have prebiotic potential which supports the growth of bacteria beneficial to the host and increases the production of short-chain fatty acids previously shown to be positive for colonic health5. Furthermore, it can improve water retention capacity in the small intestine and increases the mobility of colonic content6.

Menon et al. conducted a double-blinded, randomized, controlled trial to explore the efficacy of psyllium husk on IBS in children. Study inclusion consisted of being a child in the age group of 4-18 years, with symptoms of IBS. The study participants were classified into the following 3 subtypes of IBS: C-IBS (constipation-predominant IBS), D-IBS (diarrhea-predominant IBS), and M-IBS (mixed variety). Subjects (n=72) were randomized into 2 groups: Group A (psyllium husk group, n=41) and Group B (placebo arm, n=31). Group A received 3 g of psyllium husk and Group B received 3 g of maltodextrin. Participants ages 6-12 were given 6 g per day and those ages 13-18 were given 12 g per day in two daily divided doses. Baseline severity of IBS was calculated using the IBS-severity scoring scale (IBS-SSS) at enrollment and at 4-weeks. Primary outcomes included analyzing the number of patients who had achieved complete remission after 4 weeks of therapeutic trial.

Independent sample Student t-test was utilized for comparison of continuous variables with normal distribution. Noncontinuous variables were compared using Mann Whitney U test. Categorical data was compared using chi-square test. Regarding the total spectrum of IBS, 26 (32.1%) were D-IBS, 31 (38.27%) were C-IBS, and 24 (29.63%) were of M-IBS and they were evenly distributed among psyllium and placebo groups (p = 0.096). Based on severity, 9 (11.11%) were mild, 44 (54.32%) were moderate, and 28 (34.56%) had severe IBS. Significant findings of the 4-week trial are as follows:

  • There was a statistically significant reduction in median (IQR) of total IBS-SSS in psyllium versus placebo [75 (42.5-140) vs 225 (185-270); p < 0.001] when assessed at 4 weeks.
  • After 4 weeks of therapy, 43.9% in Group A versus 9.7% in Group B attained remission defined as IBS-SSS < 75 [p < 0.0001].
  • In the psyllium group, the mean IBS-SSS pretreatment was 265.976 ±60 and post therapy, the score decreased to 102.31 ± 94.77 (p = 0.048). In the placebo group, the mean IBS-SSS pretreatment was 289.35 ± 68.41 and post therapy, the score was 225.161 ± 106.54 (p = 0.00).

Results of the study show that psyllium husk effectively improved the severity of IBS in pediatric IBS subjects. Further research should continue to explore the use of psyllium husk for a longer period on the reduction of IBS symptoms and severity. Study limitations include the single center nature of the study, the lack of data on maintenance of remission after stopping the psyllium, and not including the nutritional profile as the outcome variable.

Source: Menon, Jagadeesh, Babu Ram Thapa, Rajni Kumari, Srikanth Puttaiah Kadyada, Satyavati Rana, and Sadhna B. Lal. “Efficacy of Oral Psyllium in Pediatric Irritable Bowel Syndrome: A Double-Blind Randomized Control Trial.” Journal of Pediatric Gastroenterology and Nutrition 76, no. 1 (2023): 14-19.

Click here to read the full text study.

Posted March 1, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Devanarayana NM, Rajindrajith S. Irritable bowel syndrome in children: Current knowledge, challenges and opportunities. World J Gastroenterol. Jun 7 2018;24(21):2211-2235. doi:10.3748/wjg.v24.i21.2211
  2. El Amrousy D, Hassan S, El Ashry H, Yousef M, Hodeib H. Vitamin D supplementation in adolescents with irritable bowel syndrome: Is it useful? A randomized controlled trial. Saudi J Gastroenterol. Mar-Apr 2018;24(2):109-114. doi:10.4103/sjg.SJG_438_17
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