Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome, 2018, Verne et al

[Tom Kindlon]

 

[Tom Kindlon]

 

[Lisa108]

The dosis of glutamine in the study was 5g three times a day.

 

[Jaybee00]

Was it any particular type of glutamine?

Thanks

(Don’t have access to article)

 

[Trish]

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.

So it looks like it's a treatment for the specific circumstances of diarrhoea following enteric infection, not a general treatment for IBS.

 

[Jenny TipsforME]

As an aside I’m trying out the Low Fodmap diet. Digestive pain was getting so intense I was starting to skip meals/ need liquid food. During the elimination phase the intense, inflammation style pain went and I felt like I slept more deeply. I’m now doing the reintroduction phase. I’ll write about this in more depth sometime.

 

[Andy]

In case it's not entirely clear to people, the study is paywalled at https://gut.bmj.com/content/early/2018/08/14/gutjnl-2017-315136, with an article based on the study at https://www.medpagetoday.com/gastroenterology/irritablebowelsyndrome/74717 (registration required).

 

[Arnie Pye]

Some years ago I took L-Glutamine powder to try and reduce inflammation and pain in my gut. I was taking a lower dose than suggested in this trial. I took it for months and it seemed to help a lot. Then I started getting horrendous pain and cramps - much worse than I had before starting the L-Glutamine. Stopping the powder returned things to "normal for me".

I think the L-Glutamine was very helpful in the early months and I would take it again. But I wouldn't take it continuously. I would build in regular breaks. But this is just hypothetical - I haven't started taking it again since it caused me so much pain.

 

[MeSci]

I've experimentally started taking just 5 mg l-glutamine every other day. On the days that I have taken it, I started feeling much more lively and clear-headed about 2-3 hours after taking it, and this lasted all evening (I took it late morning). On the day in-between, I felt muddle-headed and really weird, as has become common in the last few weeks.

If this continues, I will re-commence taking 5 mg every day, and see what happens.

I was taking it when I had my 'funny turn' in March 2016, after which I haven't really improved. Maybe this will make a difference...?

 

[MeSci]

On looking back through my diaries (I'm not very good at this at present), I found that I have taken it once a day at times since I had my 'turn', but I'm sure that it is more complex than that how often and when it should be taken.

So as I'm rather less with-it today than on the days that I have taken it, I will start taking it once a day from tomorrow and just see what happens.

It has been so refreshing to have a clear head when I have taken it!