Medically reviewed by Onikepe Adegbola, MD, PhD
Various pathophysiological causes lead to irritable bowel syndrome. IBS-C does not have a single treatment. Prebiotics may help some patients with IBS who are constipated.
Patients with IBS and constipation (IBS-C) were included in a randomized crossover case-control study, Control Study of Inulin, Choline, and Silymarin (IBS-C) published by Oana Barboi and colleagues in the Journal of Clinical Medicine.
Researchers in this trial randomly allocated two groups to a constipation diet (based on fibers, dairy, fruits) or a combination of a constipation-specific diet and a dietary supplement including inulin, choline, and silymarin. They provided participants with a questionnaire at the end of the study to measure their IBS symptoms.
This study determined whether a combination of inulin, choline, and silymarin and constipation specific may help individuals with IBS-C relieve symptoms and enhance their quality of life and to compare it with a conventional IBS-C diet alone.
Roles of Inulin and Choline
Irritable bowel syndrome (IBS) is one of the most frequent gut-brain connection disorders. This may also harm the patient’s quality of life.
Low doses of prebiotics, on the other hand, may modify gut bacteria and alleviate IBS-C symptoms. Inulin is prebiotic that cannot be digested or absorbed by humans. It stays in the intestine, where it promotes the growth of good bacteria. Inulin has been successfully used as a prebiotic to regulate intestinal transit, stool frequency, and consistency in both healthy people and IBS-C patients. Inulin has been proven in several trials to be a useful treatment for patients with IBS who suffer from constipation, particularly when ingested as part of a regular daily diet. Choline is a gastrointestinal motility enhancer that is used to treat constipation. As a result, for a randomized trial, the researcher combined both of these components.
Research Design for Randomized Crossover Studies
In a tertiary care center, researchers conducted a randomized crossover study. Fifty-one participants who had IBS-C were included in the study.
The researchers employed the closed envelope approach for randomization. Patients were separated into two groups: Group A and Group B. A constipation-specific diet was given to Group A. Group B was given the diet and a supplement containing 5000-mg inulin. This inulin was extracted from Cichorium intybus root and included 37 mg choline and 40 mg silymarin.
Group A Vs Group B
After the first 28 days, participants in group B had a considerably lower overall score for IBS symptoms than those in group A.
The number and consistency of stools per week both improved, according to the Bristol scale. In IBS-C patients, combining inulin, choline, and silymarin with the diet for constipation reduced bowel movement, stomach pain, and bloating.
Inulin, choline, and silymarin, when combined with a constipation-specific diet, exhibited clear therapeutic advantages in terms of bowel movement, abdominal pain, and bloating in IBS-C patients.
Genetic, environmental, and psychosocial factors influence the pathogenesis of IBS. As a result, physicians cannot treat IBS in a “one-size-fits-all” manner. The use of a combination of three substances, inulin, choline, and silymarin, along with a special constipation diet, showed promise in patients with IBS-C. More research on inulin could lead to more progress in treating other types of IBS.
Bărboi, O. B., Chirilă, I., Ciortescu, I., Anton, C., & Drug, V. L. (2022). Inulin, Choline, and Silymarin in the Treatment of Irritable Bowel Syndrome with Constipation-Randomized Case-Control Study. Journal of clinical medicine, 11(8), 2248. https://doi.org/10.3390/jcm11082248