Randomized Clinical Study

Partially Hydrolyzed Guar Gum (PHGG) Versus Placebo in the Treatment of Patients With Irritable Bowel Syndrome

E. Niv; A. Halak; E. Tiommny; H. Yanai; H. Strul; T. Naftali; N. Vaisman


Nutr Metab. 2016;13(10) 

In This Article


Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder.[1] It is a benign, relapsing chronic disorder characterized by recurrent abdominal pain, bloating and altered bowel function. IBS has an enormous impact on the quality of life (QOL) of the patients by causing a significant disability and absence from work and school.[2] Treatment of IBS is very problematic. Despite a wide range of pharmacological and non–pharmacological therapies, there is no universally accepted therapeutic approach.[3] The etiology and underlying pathogenesis of IBS is complex and not fully understood.[4] One of the factors that contribute to IBS is abnormality in the gut flora.[4] The gut microbiota is influenced by a diverse range of factors, including diet, fiber content in food, antibiotic usage, infection, stress, and probiotic and prebiotic use[5–7]

Guar gum is a water-soluble polysaccharide found in the seeds of guar, a plant indigenous to India and Pakistan. The main component of guar gum is galactomannan. It has been used in food processing as a thickener and emulsion stabilizer. Because guar gum is extremely viscous, it is very difficult to incorporate it in food in quantities large enough to obtain a physiological effect. The proposed solution was partial hydrolyzation of guar gum. Partially hydrolyzed guar gum (PHGG) has some attractive physical and chemical properties. It is completely water soluble, invisible in solution, taste-free, stable at a low pH, heat tolerant and is known as a prebiotic fiber. Prebiotics are defined as non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or the activity of one bacterium or a limited number of bacteria in the colon that can improve host health. PHGG increases the concentration of bifidobacterium and lactobacilli species and increases short-chain fatty acids in the colonic lumen.[8–13] It has also been shown to have a positive effect on some medical conditions, e.g., reducing blood cholesterol and controlling blood sugar levels.[14–16] In addition, it was found to be effective in the treatment of acute diarrhea in children and adult patients of intensive care units.[17–19] PHGG has proved to be effective in softening and improving fecal output and increasing bulking capacities (fecal weight, frequency of defecation, and fecal excretory feeling)[10,11,20,21] It has also been investigated as a possible treatment for IBS and found to have a positive effect, especially in constipation-predominant IBS.[22–26]

Previous studies on the use of PHGG in patients with IBS, however, were biased by methodological problems (lack of placebo group and double blind randomization, small groups, short duration of study).[5,6] We assessed the short- and long–term effects of PHGG administration on clinical symptoms of IBS patients.