title: Partially hydrolyzed guar gum in the treatment of irritable bowel syndrome with constipation: effects of gender, age, and body mass index.
abstract: OBJECTIVE
  Partially hydrolyzed guar gum (PHGG) relieves symptoms in constipation-predominant irritable bowel syndrome (IBS) and may have prebiotic properties. However, the correlation between the effectiveness of PHGG and patient characteristics has not been examined. We aimed to investigate the effect of PHGG in symptom relief on constipation-predominant IBS according to gender, age, and body mass index (BMI).
  
  
  METHODS
  Sixty-eight patients with IBS entered a 2-week run-in period, followed by a 4-week study period with PHGG. Patients completed a daily questionnaire to assess the presence of abdominal pain/discomfort, swelling, and the sensation of incomplete evacuation. The number of evacuations/day, the daily need for laxatives/enemas and stool consistency-form were also evaluated. All patients also underwent a colonic transit time (CTT) evaluation.
  
  
  RESULTS
  PHGG administration was associated with a significant improvement in symptom scores, use of laxatives/enemas, stool form/consistency and CTT. At the end of the study period and compared with baseline, the number of evacuations improved in women, patients aged ≥ 45 years and those with BMI ≥ 25 (P < 0.05 for all comparisons); abdominal bloating improved in males (P < 0.05), patients < 45 years (P < 0.01) and those with BMI < 25 (P < 0.05). A decrease in the number of perceived incomplete evacuations/day was reported in patients with a BMI ≥ 25 (P < 0.05). Reductions in laxative/enema use were recorded in females (P < 0.05), patients < 45 years (P < 0.01), and patients with BMI < 25 (P < 0.05).
  
  
  CONCLUSIONS
  Gender, age, and BMI seem to influence the effect of PHGG supplementation in constipated IBS patients. Further studies are needed to clarify the interaction of such parameters with a fiber-enriched diet.
authors.forename: Luigi
authors.initials: L
authors.lastname: Russo
authors.forename: Paolo
authors.initials: P
authors.lastname: Andreozzi
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Zito
authors.forename: Letizia
authors.initials: L
authors.lastname: Vozzella
authors.forename: Ivana G
authors.initials: IG
authors.lastname: Savino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sarnelli
authors.affiliation: Department of Clinical Medicine and Surgery, Gastroenterological Unit, University Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Cuomo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003248:Constipation / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D004043:Dietary Fiber / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005685:Galactans / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008351:Mannans / Q000627:therapeutic use*; D008875:Middle Aged; D053149:Plant Gums / Q000627:therapeutic use*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D055815:Young Adult
chemical_list: D004043:Dietary Fiber; D005685:Galactans; D008351:Mannans; D053149:Plant Gums; C007894:guar gum
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