Efficacy of Oral Psyllium in Pediatric Irritable Bowel Syndrome

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 76; no. 1; pp. 14 - 19
• Main Authors: Menon, Jagadeesh, Thapa, Babu Ram, Kumari, Rajni, Puttaiah Kadyada, Srikanth, Rana, Satyavati, Lal, Sadhna B.
• Format: Journal Article
• Language: English
• Published: 01-01-2023
• Subjects: IBS severity scoring scale; irritable bowel syndrome; placebo; psyllium husk; therapeutic trial
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/MPG.0000000000003622

Objective:
Pediatric irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder with variable response to various therapeutic agents. Psyllium has been proven to be effective in adults; however, there is no study in children. The objective of this study is to evaluate the efficacy of psyllium husk as compared to placebo in pediatric IBS patients.
Methods:
In this double‐blind randomized controlled trial, 43 children were assigned to psyllium arm (Group A) and 38 into placebo arm (Group B). Severity is assessed at baseline and after 4 weeks of treatment using IBS severity scoring scale (IBS‐SSS) and classified into mild, moderate, and severe categories. Categorical data was compared with chi‐square test and paired categorical variable was compared with McNemer test.
Results:
Mean ages (±SD; in years) of Groups A and B were 9.87 (2.7) and 9.82 (3.17), respectively, with median duration of illness of 12 months. At baseline, type, severity, and parameters (IBS‐SSS) of IBS were equally distributed in 2 groups. There was a significant reduction in median interquartile range (IQR) of total IBS‐SSS in psyllium versus placebo [75 (42.5–140) vs 225 (185–270); P < 0.001] at 4 weeks. Similarly 43.9% in Group A versus 9.7% in Group B attained remission [IBS‐SSS < 75 (P < 0.0001)]. The mean difference in IBS‐SSS between Group A and Group B was −122.85 with risk ratio of 0.64 (95% CI; 0.42–0.83; P= 0.001) and absolute risk reduction of 32% (NNT = 3).
Conclusions:
Psyllium husk is effective for the therapy of pediatric IBS when compared with placebo in short term.