title: Does oral α-galactosidase relieve irritable bowel symptoms?
abstract: OBJECTIVE
  Abdominal bloating is reported by a majority of irritable bowel syndrome (IBS) patients. Excess colonic fermentation may cause gaseous symptoms. Several foodstuffs contain oligosaccharides with an α-galactosidic linkage that is resistant to mammalian hydrolases. Assisted hydrolysis by exogenous α-galactosidase enzyme (AG) could offer a way of controlling IBS symptoms by reducing colonic fermentation and gas production. The aim of this study was to assess the effect of AG on symptom severity and quality of life in IBS patients with abdominal bloating or flatulence.
  
  
  METHODS
  A total of 125 subjects with IBS received AG or placebo at meals for 12 weeks. IBS-Symptom Severity Score (IBS-SSS) and quality of life (QoL) were assessed at baseline, during the treatment and at 4-week follow-up.
  
  
  RESULTS
  AG showed a trend toward a more prominent decrease in IBS-SSS. The responder rate at week 16 was higher for the AG group. No difference was detected in QoL between AG and placebo groups. A total of 25 patients (18 in AG group and 7 in placebo group, p = 0.016) withdrew from the study. Abdominal pain and diarrhea were more often reported as reason for withdrawal in AG group.
  
  
  CONCLUSIONS
  We found no evidence to support the use of AG routinely in IBS patients. Improvement of clinical response at 4-week follow-up may suggest a long-term effect of unknown mechanism, but could also be attributed to non-responder drop out. Gastrointestinal (GI) side effects may be a coincidence in this study, but irritation of GI tract by AG administration cannot be excluded.
authors.affiliation: a 1 Aava Gastroenterology Clinic , Helsinki, Finland.|b 2 Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital , Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Hillilä
authors.affiliation: b 2 Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital , Helsinki, Finland.
authors.forename: Martti A
authors.initials: MA
authors.lastname: Färkkilä
authors.affiliation: a 1 Aava Gastroenterology Clinic , Helsinki, Finland.|b 2 Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital , Helsinki, Finland.
authors.forename: Taina
authors.initials: T
authors.lastname: Sipponen
authors.affiliation: a 1 Aava Gastroenterology Clinic , Helsinki, Finland.
authors.forename: Janne
authors.initials: J
authors.lastname: Rajala
authors.affiliation: a 1 Aava Gastroenterology Clinic , Helsinki, Finland.|b 2 Clinic of Gastroenterology, University of Helsinki and Helsinki University Hospital , Helsinki, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Koskenpato
mesh_terms: D015746:Abdominal Pain; D000284:Administration, Oral; D000328:Adult; D003967:Diarrhea; D005260:Female; D005387:Finland; D005414:Flatulence / Q000188:drug therapy*; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D000519:alpha-Galactosidase / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D005765:Gastrointestinal Agents; D000519:alpha-Galactosidase
keywords: abdominal pain; carbohydrates; diet; flatulence; irritable bowel syndrome; α-galactosidase