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Published on: January 5, 2024

Randomized Placebo-Controlled Trial of Psyllium Fiber in Functional Abdominal Pain Disorders in Children

Manjit Kaur1, Ujjal Poddar2, Anshu Srivastava1

  • 1Department of Pediatric Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.

Digestive Diseases and Sciences
|August 5, 2026
PubMed

Insights

Psyllium fiber significantly improved pain and quality of life in children with functional abdominal pain disorders (FAPD), including functional abdominal pain-not otherwise specified (FAP-NOS) and irritable bowel syndrome (IBS). Most children experienced sustained relief after treatment cessation.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Evidence-Based Medicine

Background:

  • Functional abdominal pain disorders (FAPD) are prevalent in children, with limited research on fiber's role, especially in functional abdominal pain-not otherwise specified (FAP-NOS).
  • Heterogeneity in existing literature necessitates further investigation into effective treatments for pediatric FAPD.

Purpose of the Study:

  • To assess the efficacy of psyllium fiber in managing pediatric FAPD, encompassing Irritable Bowel Syndrome (IBS) and FAP-NOS.
  • To compare improvements in pain and quality of life (QoL) between psyllium fiber and placebo interventions.

Main Methods:

  • A prospective randomized placebo-controlled trial involving 109 children (5-18 years) diagnosed with FAPD according to Rome IV criteria.
  • Participants received either psyllium fiber or a placebo (maltodextrin) for 12 weeks, with pain and QoL assessed pre- and post-treatment.
  • Pain was evaluated based on intensity, frequency, and duration, alongside QoL measures.

Main Results:

  • Psyllium fiber significantly reduced pain intensity, frequency, and duration, and improved QoL compared to placebo (P < 0.001 for all).
  • 86% of children in the psyllium group were responders ( >50% pain reduction) versus 60% in the placebo group (P = 0.001).
  • Psyllium fiber use was the sole predictor of response (OR: 5.49), with 81% maintaining sustained relief post-treatment.

Conclusions:

  • A 12-week psyllium fiber intervention effectively improves pain and quality of life in children with FAP-NOS and IBS.
  • The majority of pediatric patients experience sustained pain relief after discontinuing psyllium fiber.
Abstract

Keywords:
Functional abdominal pain-not otherwise specifiedIrritable bowel syndromePediatricPsyllium huskRandomisation

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