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Consensus on whether fiber supplementation improves symptoms of irritable bowel syndrome (IBS) has wavered over the years. This new meta-analysis, which includes 14 randomized trials and 906 patients, addresses the question once again. In half the studies, patients used bran and, in the other half, they used psyllium (soluble fiber).
The primary outcome was global assessment of IBS symptoms. Psyllium was associated with statistically significant improvement in symptoms (and no evident harms), but seven patients had to be treated to benefit one patient. For bran, a modest benefit did not reach statistical significance. The most recent large trial (BMJ 2009; 339:b3154) — a 275-patient, 12-week comparison between bran, psyllium, and placebo — w…