Oral dietary glutamine supplements helped patients improve symptoms of postinfectious diarrhea predominant irritable bowel syndrome, according to research published in Gut.
QiQi Zhou, MD, PhD, MBA, of the department of medicine at Tulane School of Medicine, and colleagues hypothesized that glutamine could potentially be used as a therapy for IBS, an area where current treatments are “unsatisfactory.”
“Glutamine, an essential amino acid in humans, is a major energy source for rapidly dividing epithelial cells of the gastrointestinal tract,” they wrote. “Depletion of glutamine during infection or illness leads to atrophy of intestinal epithelial cells and intestinal hyperpermeability.”
Zhou and colleagues tested the efficacy and safety of an oral glutamine supplement in a randomized, placebo-controlled trial. They included patients aged 18 to 72 with IBS-D and documentation of an enteric infection.
Patients received either a glutamine supplement (n = 54) or placebo (n = 52) for 8 weeks. The primary endpoint was a reduction of at least 50 points on the Irritable Bowel Syndrome Severity Scoring System (IBS-SS).
More patients in the glutamine group achieved the primary endpoint compared with patients in the placebo group (79.6% vs. 5.8%; P < .0001). Patients in the glutamine group also achieved better mean results in the secondary outcome measures: IBS-SS score at 8 weeks (301 vs. 181; P < .0001); daily bowel movement frequency (5.4 vs. 2.9; P < .0001); Bristol stool scale (6.5 vs. 3.9; P < .0001); and intestinal permeability (0.11 vs. 0.05; P < .0001).
Zhou and colleagues also found that adverse events were low and similar in both groups and observed no serious adverse events.
Researchers wrote that glutamine’s mechanism might involve normalization and hyperpermeability. They called for further research to determine the long-term efficacy of a glutamine treatment for IBS.
“Our results and others suggest that glutamine’s mechanism of action may be restoring normal intestinal permeability, which leads to improved gastrointestinal symptoms,” the researchers wrote. “Additional evidence suggests that glutamine directly modulates intestinal permeability in patients with IBS-D.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.