Abstract :
Background: Diet plays an important role in the management of the irritable bowel syndrome (IBS).
Previous studies have suggested that, compared to wheat, rice is more completely absorbed in the small bowel and
is associated with less intestinal gas and gastrointestinal (GI) symptoms. The benefit of rice carbohydrate in IBS,
however, has not been clearly demonstrated.
Objective: To determine the effect of rice flour on intestinal hydrogen gas production and IBS symptoms,
compared to wheat or mungbean flour.
Method: Twenty non-constipation IBS patients (13 females, age 46±11 yrs) underwent H2 breath test
study and GI symptom evaluation after ingestion of standard rice, wheat or mungbean meals (90 gm-dry weight).
Subjects were randomized in a double-blind crossover study, with a 1-week washout period. After an overnight
fast, intestinal gas production and GI symptom scores in response to the standard meals (given at 8 AM and 12 PM)
were evaluated at baseline and every 15-minute for 8 hours after the first standard meal. GI symptoms were evaluated
using the visual analog scales.
Results: All subjects completed the study without any adverse events. The hydrogen (H2) and methane
(CH4) concentrations in the breath samples were similar at baseline (p>0.05). Beginning at hour-5 after breakfast,
the H2 and CH4 productions were significantly increased after wheat noodle ingestion compared to rice noodle
ingestion (p<0.05). The area under curves (AUC) of H2 and CH4 were greater after wheat noodle ingestion compared
to rice and mungbean noodle ingestion (H2: 4,120.5 ± 45.5 vs. 2,267.3 ± 14.6 and 2,356.1±13.9 ppm-min,
p<0.001 and CH2 : 1,616.0 ± 15.8 vs. 946.5 ± 6.0 and 943.1±5.2 ppm-min, p<0.05). The mean symptom scores for
bloating and satiety symptoms were significantly increased after wheat ingestion compared to rice ingestion (3.0 ±
0.6 vs. 2.2 ± 0.6 and 3.4 ± 0.5 vs. 2.5 ± 0.5, respectively, p<0.05). Other GI symptoms including abdominal pain,
abdominal burning, nausea, urgency of stool, heartburn, belching and regurgitation were not significantly different
between after rice and wheat ingestion.
Conclusion: Rice flour ingestion produces significantly less intestinal gas production, bloating and
satiety symptom compared to wheat flour ingestion. The results suggested that rice is a better source of carbohydrate
for non-constipation IBS compared to wheat or mungbean carbohydrate. |
file/Thai-Journal-of-gastroenterology-vol-15-no-3-1863253.pdf