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Partially Hydrolyzed Guar Gum Accelerates Colonic Transit Time and Improves Symptoms in Adults with Chronic Constipation

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Abstract

Background and Aim

Partially hydrolyzed guar gum (PHGG) is a water-soluble, non-gelling dietary fiber with a wide range of uses in clinical nutrition. The aim of this prospective study was to investigate the effect of guar gum on colonic transit time (CTT) and symptoms of chronic constipation.

Methods

We enrolled patients fulfilling Rome III criteria for chronic constipation. CTT was measured before and at the end of treatment. After a 2-week run-in period, patients received 5 mg PHGG daily for 4 weeks. During study period, patients kept daily symptoms, stool and laxative usage diaries. They also recorded their symptom-related satisfaction weekly and treatment adverse events.

Results

Forty-nine patients received treatment; 39 (80 %) completed the study. Treatment significantly reduced colon transit time, from 57.28 ± 39.25 to 45.63 ± 37.27 h (p = 0.026), a reduction more prominent in slow transit patients (from 85.50 ± 27.75 to 63.65 ± 38.11 h, p = 0.016). Overall, the weekly number of complete spontaneous and spontaneous bowel movements increased significantly (p < 0.001); the latter correlated significantly with the acceleration of CTT in the overall population and in slow transit patients (B = 0.382; p = 0.016 and B = 0.483; p = 0.023, respectively). In addition, the number of bowel movements with straining decreased (p < 0.001) and stool form improved (p < 0.001), while days with laxative intake and days with abdominal pain decreased (p = 0.001 and p = 0.027, respectively).

Conclusion

Four-week PHGG use accelerates colon transit time in patients with chronic constipation, especially in those with slow transit, and improves many of their symptoms including frequency of bowel movements.

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Abbreviations

PHGG:

Partially hydrolyzed guar gum

CTT:

Colonic transit time

CSBM:

Complete spontaneous bowel movements

SBM:

Spontaneous bowel movements

SCFAs:

Short-chain fatty acids

References

  1. Lembo A, Camilleri M. Chronic constipation. N Engl J Med. 2003;349:1360–1368.

    Article  CAS  PubMed  Google Scholar 

  2. Papatheodoridis GV, Vlachogiannakos J, Karaitianos I, Karamanolis DG. A Greek survey of community prevalence and characteristics of constipation. Eur J Gastroenterol Hepatol. 2010;22:354–360.

    Article  PubMed  Google Scholar 

  3. Yoon SJ, Chu DC, Juneja L. Chemical and physical properties, safety and application of partially hydrolyzed guar gum as dietary fiber. J Clin Biochem Nutr. 2008;42:1–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Slavin JL, Greenberg NA. Partially hydrolyzed guar gum. Clinical nutrition uses. Nutrition. 2003;19:549–552.

    Article  CAS  PubMed  Google Scholar 

  5. Roberfroid M, Slavin JL. Non digestible oligosaccharides. Crit Rev Food Sci Nutr. 2000;40:461–480.

    Article  CAS  PubMed  Google Scholar 

  6. Linetzky Waitzberg D, Alves Pereira CC, Logullo L, et al. Microbiota benefits after inulin and partially hydrolyzed guar gum supplementation: a randomized clinical trial in constipated women. Nutr Hosp. 2013;27:123–129.

    Google Scholar 

  7. Bijkerk CJ, Muris JW, Knottnerus JA, Hoes AW, de Wit NJ. Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2004;19:245–251.

    Article  CAS  PubMed  Google Scholar 

  8. Bove A, Bellini M, Battaglia E, et al. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment). World J Gastroenterol. 2012;18:4994–5013.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Takahashi H, Yang SI, Hayashi C, Kim M, Yamanaka J, Yamamoto T. Effect of partially hydrolyzed guar gum on fecal output in human volunteers. Nutr Res. 1993;13:649–657.

    Article  CAS  Google Scholar 

  10. Takahashi H, Wako N, Okubo T, Ishihara N, Yamanaka J, Yamamoto T. Influence of partially hydrolyzed guar gum on constipation in women. J Nutr Sci Vitaminol. 1994;40:251–259.

    Article  CAS  PubMed  Google Scholar 

  11. Yamatoya K, Kuwano K, Suzuki J, Mitamura T, Sekeiya K. Effect of hydrolyzed guar gum on frequency and feeling of defecation in humans. J Appl Glycosci. 1995;42:251–257.

    CAS  Google Scholar 

  12. Cummings JH, Branch W, Jenskins DJ, Southgate DA, Houston H, James WP. Colonic response to dietary fiber from carrot, cabbage, apple, bran and guar gum. Lancet. 1978;1:5–9.

    Article  CAS  PubMed  Google Scholar 

  13. Penagini R, Velio P, Vigorelli R, et al. The effect of dietary guar on serum cholesterol, intestinal transit and fecal output in man. Am J Gastroenterol. 1986;81:123–125.

    CAS  PubMed  Google Scholar 

  14. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997;32:920–924.

    Article  CAS  PubMed  Google Scholar 

  15. Sloots CE, Felt-Bersma RJ. Effect of bowel cleansing on colonic transit in constipation due to slow transit or evacuation disorder. Neurogastroenterol Motil. 2002;14:55–61.

    Article  CAS  PubMed  Google Scholar 

  16. Castillejo G, Bulló M, Anguera A, Escribano J, Salas-Salvadó J. A controlled, randomized, double-blind trial to evaluate the effect of a supplement of cocoa husk that is rich in dietary fiber on colonic transit in constipated pediatric patients. Pediatrics. 2006;118:641–648.

    Article  Google Scholar 

  17. Üstündağ G, Kuloğlu Z, Kirbaş N, Kansu A. Can partially hydrolyzed guar gum be an alternative to lactulose in treatment of childhood constipation? Turk J Gastroenterol. 2010;21:360–364.

    PubMed  Google Scholar 

  18. Parisi GC, Zilli M, Miani MP, et al. High-fiber diet supplementation in patients with irritable bowel syndrome (IBS). Comparison between wheat bran diet and partially hydrolyzed guar gum (PHGG). Dig Dis Sci. 2002;47:1697–1704.

    Article  CAS  PubMed  Google Scholar 

  19. Bharucha AE, Pemberton JH, Locke GR III. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013;144:218–238.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Romano C, Comito D, Famiani A, Calamarà S, Loddo I. Partially hydrolyzed guar gum in pediatric functional abdominal pain. World J Gastroenterol. 2013;19:235–240.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Alam NH, Meier R, Rausch T, et al. Effects of a partially hydrolyzed guar gum on intestinal absorption of carbohydrate, protein and fat: a double blind controlled study in volunteers. Clin Nutr. 1998;17:125–129.

    Article  CAS  PubMed  Google Scholar 

  22. Meier R, Beglinger C, Pullwitt A, Meier-Wyss B, Brignoli R. How reliable is the measurement of colonic transit time using a marker technique? Schweiz Med Wochenschr. 1995;125:1830–1833.

    CAS  PubMed  Google Scholar 

  23. Nam YS, Pikarsky AJ, Wexner SD, et al. Reproducibility of colonic transit study in patients with chronic constipation. Dis Colon Rectum. 2001;44:86–92.

    Article  CAS  PubMed  Google Scholar 

  24. Kamm MA, Müller-Lissner S, Talley NJ, et al. Tegaserod for the treatment of chronic constipation: a randomized, double-blind, placebo-controlled multinational study. Am J Gastroenterol. 2005;100:362–372.

    Article  CAS  PubMed  Google Scholar 

  25. Quigley EM, Vandeplassche L, Kerstens R, Ausma J. Clinical trial: the efficacy, impact on quality of life, and safety and tolerability of prucalopride in severe chronic constipation—a 12-week, randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther. 2009;29:315–328.

    Article  CAS  PubMed  Google Scholar 

  26. Lembo AJ, Schneier HA, Shiff SJ, et al. Two randomized trials of linaclotide for chronic constipation. N Engl J Med. 2011;365:527–536.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

Novartis (Hellas) Consumer Health provided the markers for the colon transit time measurement.

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Authors and Affiliations

  1. Hepatogastroenterology Unit, Second Department of Internal Medicine and Research Institute, Attikon University General Hospital, Medical School, Athens University, Rimini 1, 124 62, Athens, Greece

    Dimitrios Polymeros, Iosif Beintaris, Asimina Gaglia, George Karamanolis, Ioannis S. Papanikolaou, George Dimitriadis & Konstantinos Triantafyllou

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  1. Dimitrios Polymeros
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  2. Iosif Beintaris
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  3. Asimina Gaglia
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  4. George Karamanolis
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  6. George Dimitriadis
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  7. Konstantinos Triantafyllou
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Correspondence to Dimitrios Polymeros.

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Polymeros, D., Beintaris, I., Gaglia, A. et al. Partially Hydrolyzed Guar Gum Accelerates Colonic Transit Time and Improves Symptoms in Adults with Chronic Constipation. Dig Dis Sci 59, 2207–2214 (2014). https://doi.org/10.1007/s10620-014-3135-1

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  • DOI: https://doi.org/10.1007/s10620-014-3135-1

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