# ASSESSING PSYLLIUM GIVEN WITH MEALS FOR FRUCTAN SENSITIVITY IN CHILDREN WITH IRRITABLE BOWEL SYNDROME

> **NIH NIH R01** · DUKE UNIVERSITY · 2024 · $302,041

## Abstract

PROJECT SUMMARY
 Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction that affects up to 20% of school children
worldwide. Dietary interventions, particularly those removing fermentable oligosaccharides disaccharides
monosaccharides and polyols (FODMAP) carbohydrates from the diet, may be helpful in both adults and children
with IBS. Unfortunately, there are significant practical and potential health challenges (e.g., unintended weight
loss) to following a FODMAP restriction diet. Identifying new therapies beyond dietary restriction alone for
FODMAP-induced symptoms, particularly in children, is needed.
 Fructans are a type of FODMAP that are naturally occurring, abundant in our diet, and are a major focus
of restriction in the low FODMAP diet. After ingestion, fructans arrive in the colon essentially intact where they
are fermented rapidly by gut microbiota. We identified that a subset (~50%) of children with IBS are fructan-
sensitive meaning they experience worsening abdominal pain when fed fructans. The biggest distinguishing
feature between those who are fructan-sensitive vs. fructan tolerant (do not develop worsening pain) is a distinct
microbial composition and fermentation pattern. These data suggest fructan fermentation by the gut microbiota
is an important factor in determining whether subsequent gastrointestinal symptoms develop.
 Psyllium is a viscous, soluble, poorly fermented fiber that we demonstrated in children with IBS decreases
abdominal pain frequency. However, psyllium efficacy is modest and the mechanism by which it ameliorates IBS
is unknown. Importantly, a recent study reported that psyllium administered concurrently with fructans affected
fructan fermentation: Adults who consumed fructans with psyllium (vs. fructans alone) had both decreased
colonic gas production and overall colonic volume. This means psyllium represents a potentially important clinical
intervention that may avoid the need for dietary fructan (and other FODMAPs) restriction and needs to be tested.
 To begin to investigate psyllium treatment for FODMAP (fructan)-induced pain, we will first identify children
with IBS who are fructan-sensitive using our established randomized crossover protocol. Following a two-week
baseline period In those who are fructan-sensitive (n=45), we then propose a two-week double-blind randomized
parallel-group study in which participants receive either psyllium (1 g/year of age or 0.5 g/year of age per day)
with fructans or a placebo (glucose) with fructans. Our central hypothesis is that psyllium given with fructans to
fructan-sensitive children with IBS will decrease colonic fermentation of fructans and fructan-induced
gastrointestinal symptoms. The Specific Aims of the project are to: 1) Investigate the effect of psyllium at two
doses given with a fructan meal on microbial fructan fermentation; 2) Determine the effect of psyllium given with
a fructan meal on fructan-induced gastrointestinal symptoms. The know...

## Key facts

- **NIH application ID:** 10802749
- **Project number:** 1R01DK135668-01A1
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Bruno Pedro Chumpitazi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $302,041
- **Award type:** 1
- **Project period:** 2024-08-05 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10802749

## Citation

> US National Institutes of Health, RePORTER application 10802749, ASSESSING PSYLLIUM GIVEN WITH MEALS FOR FRUCTAN SENSITIVITY IN CHILDREN WITH IRRITABLE BOWEL SYNDROME (1R01DK135668-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10802749. Licensed CC0.

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