A randomized double‐blind placebo‐controlled crossover pilot study: Acute effects of the enzyme α‐galactosidase on gastrointestinal symptoms in irritable bowel syndrome patients

• Published in: Neurogastroenterology and motility Vol. 33; no. 7; pp. e14094 - n/a
• Main Authors: Böhn, Lena, Törnblom, Hans, Van Oudenhove, Lukas, Simrén, Magnus, Störsrud, Stine
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.07.2021
• Subjects: Acute effects; Adult; Aged; alpha-Galactosidase - therapeutic use; breath tests; carbohydrates; Cross-Over Studies; Double-Blind Method; Double-blind studies; Female; Gas production; Gastroenterologi och hepatologi; Gastroenterology & Hepatology; Gastroenterology and Hepatology; Humans; Hydrogen; Intestine; Irritable bowel syndrome; Irritable Bowel Syndrome - drug therapy; Male; Meals; Methane; Middle Aged; Neurosciences & Neurology; Oligosaccharides; Pilot Projects; Placebos; postprandial; postprandial symptoms; symptoms; carbohydrates; postprandial symptoms; irritable bowel syndrome; breath tests
• ISSN: 1350-1925; 1365-2982; 1365-2982
• DOI: 10.1111/nmo.14094

ABSTRACT Background Postprandial symptoms presumably related to intestinal gas production are common in patients with irritable bowel syndrome (IBS). The aim of the study was to assess if oral α‐galactosidase is superior to placebo in reducing gastrointestinal (GI) symptoms and intestinal gas production after ingestion of carbohydrate‐rich meals in adult patients with IBS. Methods We studied the effect of 1200 GaIU/meal α‐galactosidase (Nogasin®) or placebo capsules on GI symptoms in patients with IBS after three standardized, meals high in oligosaccharides, in a randomized, double‐blind, crossover study. The intensity of eight GI symptoms was rated, and breath hydrogen and methane were measured every 30 min during 7.5 h. The severity of GI symptoms the following morning was assessed and compared with baseline.S Key Results Twenty adult patients with IBS (19 females), mean age 49 years (range 22–75 years), were included. All test meals were well tolerated but induced a gradual increase in GI symptom severity. Neither GI symptom ratings over time, nor hydrogen and methane concentrations differed between the days with α‐galactosidase or placebo. The severity of abdominal pain and bloating was lower the following morning, but with no differences between α‐galactosidase and placebo. Conclusions & Inferences The use of α‐galactosidase together with meals high in oligosaccharides was in this pilot study not superior to placebo in reducing postprandial GI symptoms or the concentration of hydrogen and methane in expired air in IBS. The use of α‐galactosidase together with meals high in oligosaccharides was in this pilot study not superior to placebo in reducing postprandial gas or other gastrointestinal symptoms or the concentration of hydrogen in expired air in adult IBS subjects.