Cited by 195Gastrointestinal motility and disordersGut microbiota and healthInflammatory Bowel Disease

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Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome

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Zhou, QiQi, Verne, Meghan L, Fields, Jeremy Z, Lefante, John J, Basra, Sarpreet, Salameh, Habeeb, Verne, G Nicholas·2019·Gut

DOI 10.1136/gutjnl-2017-315136PMC PMC9549483

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Abstract

Background: More effective treatments are needed for patients with postinfectious, diarrhoea-predominant, irritable bowel syndrome (IBS-D). Accordingly, we conducted a randomised, double-blind, placebo-controlled, 8-week-long trial to assess the efficacy and safety of oral glutamine therapy in patients who developed IBS-D with increased intestinal permeability following an enteric infection. Methods: Eligible adults were randomised to glutamine (5 g/t.i.d.) or placebo for 8 weeks. The primary end point was a reduction of ≥50 points on the Irritable Bowel Syndrome Severity Scoring System (IBS-SS). Secondary endpoints included: raw IBS-SS scores, changes in daily bowel movement frequency, stool form (Bristol Stool Scale) and intestinal permeability. Results: Fifty-four glutamine and 52 placebo subjects completed the 8-week study. The primary endpoint occurred in 43 (79.6%) in the glutamine group and 3 (5.8%) in the placebo group (a 14-fold difference). Glutamine also reduced all secondary endpoint means: IBS-SS score at 8 weeks (301 vs 181, p<0.0001), daily bowel movement frequency (5.4 vs 2.9±1.0, p<0.0001), Bristol Stool Scale (6.5 vs 3.9, p<0.0001) and intestinal permeability (0.11 vs 0.05; p<0.0001). ‘Intestinal hyperpermeability’ (elevated urinary lactulose/mannitol ratios) was normalised in the glutamine but not the control group. Adverse events and rates of study-drug discontinuation were low and similar in the two groups. No serious adverse events were observed. Conclusions: In patients with IBS-D with intestinal hyperpermeability following an enteric infection, oral dietary glutamine supplements dramatically and safely reduced all major IBS-related endpoints. Large randomised clinical trials (RCTs) should now be done to validate these findings, assess quality of life benefits and explore pharmacological mechanisms. Trial registration number: NCT1414244 ; Results.

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Authors: Zhou, Q., Verne, M. L., Fields, J. Z., Lefante, J. J., Basra, S., Salameh, H., & Verne, G. N.
Affiliations: Tulane University (US)
Texas A&M Health Science Center (US)
The University of Texas Medical Branch at Galveston (US)
Corresponding author: Verne, G Nicholas
ORCID: Zhou, QiQi
Verne, G Nicholas
Venue: Gut
Publisher: BMJ
Published: 2018-08-14
Volume: 68
Issue: 6
Pages: 996-1002
ISSN: 0017-5749 (ISSN-L)
1468-3288
DOI: 10.1136/gutjnl-2017-315136
PMC: PMC9549483
OpenAlex: W2888929155
Cited by: 195
References: 40
Citations by year: 2026: 21 · 2025: 30 · 2024: 26 · 2023: 22 · 2022: 21 · 2021: 26 · 2020: 31 · 2019: 13 · 2018: 5
FWCI: 17.87
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Gut (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: National Institute of General Medical Sciences
National Institute of Diabetes and Digestive and Kidney Diseases
National Center for Complementary and Integrative Health
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
Keywords: dietary glutamine, post-infectious irritable bowel syndrome, diarrhoea-predominant IBS, intestinal permeability, leaky gut, gastrointestinal infections, lactulose/mannitol ratio, IBS symptom severity, stool frequency, stool consistency, oral supplementation
MeSH terms: Administration, Oral, Adult, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Enteritis, Female, Glutamine, Humans, Intestinal Mucosa, Male, Reference Values, Severity of Illness Index, Treatment Outcome, Risk Assessment, Dietary Supplements, Irritable Bowel Syndrome

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Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome

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