Article

Efficacy of ground flaxseed on constipation in patients with irritable bowel syndrome

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  • Mediquantum
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Abstract

We studied in an investigator-blinded trial the efficacy of roughly ground partly defatted flaxseed on constipation in 55 patients suffering from constipation predominant irritable bowel syndrome. Fifty-five patients were randomised to receive 6-24 g/d either flaxseed or psyllium for 3 months. During the blinded treatment period 26 patients received flaxseed and 29 received psyllium. In flaxseed group, constipation and abdominal symptoms were decreased significantly (p=0.002) whereas in psyllium group the reduction was not statistically significant. After the blinded treatment period, the difference between groups was statistically significant in constipation (p=0.05) and in bloating and pain (p=0.001). Forty patients continued to the open period with flaxseed treatment only, 18 from flaxseed group and 22 from psyllium group. After the open period of 3 months, constipation and abdominal symptoms were further significantly reduced (p=0.001). Safety laboratory values were unchanged with exception of serum thiocyanate that increased from 40.9 to 153.7 μmol/l in flaxseed group. After additional 3 months' treatment with flaxseed this value was decreased to 104 mmol/l. Blood cadmium was normal (3.4 nmol/l) after six months' flaxseed treatment.

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... Included studies and evidence statements Ten RCTs fulfilled the inclusion criteria and were evaluated as summarised in Table 5 (Arffmann et al., 1985;Kruis et al., 1986;Lucey et al., 1987;Fowlie et al., 1992;Snook & Shepherd, 1994;Hebden et al., 2002;Aller et al., 2004;Tarpila et al., 2004;Rees et al., 2005;Bijkerk et al., 2009). They assessed NSP intake using wheat bran, linseeds (ground) or combined food sources. ...
... No interventions used oats, other bran types or whole linseeds. The following evidence statements were developed: 2.1 There is moderate good evidence that wheat bran fibre does not improve IBS symptoms (Kruis et al., 1986;Lucey et al., 1987;Snook & Shepherd, 1994;Hebden et al., 2002;Rees et al., 2005;Bijkerk et al., 2009) SIGN 1) 2.2 There is limited weak evidence that increasing NSP from mixed food sources does not improve IBS symptoms (Fowlie et al., 1992;Aller et al., 2004) SIGN 2) 2.3 There is limited weak evidence that ground linseeds relieve constipation, abdominal discomfort and bloating in IBS-C (Tarpila et al., 2004) SIGN 2) 2.4 There is limited weak evidence that IBS-C symptoms improve slowly over time in response to ground linseeds (Tarpila et al., 2004) SIGN 2) ...
... No interventions used oats, other bran types or whole linseeds. The following evidence statements were developed: 2.1 There is moderate good evidence that wheat bran fibre does not improve IBS symptoms (Kruis et al., 1986;Lucey et al., 1987;Snook & Shepherd, 1994;Hebden et al., 2002;Rees et al., 2005;Bijkerk et al., 2009) SIGN 1) 2.2 There is limited weak evidence that increasing NSP from mixed food sources does not improve IBS symptoms (Fowlie et al., 1992;Aller et al., 2004) SIGN 2) 2.3 There is limited weak evidence that ground linseeds relieve constipation, abdominal discomfort and bloating in IBS-C (Tarpila et al., 2004) SIGN 2) 2.4 There is limited weak evidence that IBS-C symptoms improve slowly over time in response to ground linseeds (Tarpila et al., 2004) SIGN 2) ...
Article
 Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder. Diet and lifestyle changes are important management strategies. The aim of these guidelines is to systematically review key aspects of the dietary management of IBS, with the aim of providing evidence-based guidelines for use by registered dietitians. Questions relating to diet and IBS symptom management were developed by a guideline development group. These included the role of milk and lactose, nonstarch polysaccharides (NSP), fermentable carbohydrates in abdominal bloating, probiotics and empirical or elimination diets. A comprehensive literature search was conducted and relevant studies from January 1985 to November 2009 were identified using the electronic database search engines: Cinahl, Cochrane Library, Embase, Medline, Scopus and Web of Science. Evidence statements, recommendations, good practice points and research recommendations were developed. Thirty studies were critically appraised. A dietetic care pathway was produced following a logical sequence of treatment and formed the basis of these guidelines. Three lines of dietary management were identified. first line: Clinical and dietary assessment, healthy eating and lifestyle management with some general advice on lactose and NSP. Second line: Advanced dietary interventions to improve symptoms based on NSP, fermentable carbohydrates and probiotics. Third line: Elimination and empirical diets. Research recommendations were also identified relating to the need for adequately powered and well designed randomised controlled trials. These guidelines provide evidence-based details of how to achieve the successful dietary management of IBS.
... -+ + -- Snook and Shepherd (1994) (73) + ? (75) ? ...
... Included studies and evidence statements One new and 10 previously evaluated level II RCTs met the inclusion criteria (Table 6) (66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76) . The new study was a parallel open-label, multicentre study assessing linseed (i.e. ...
... Dietary fibre intake was reported at baseline and post intervention in five RCTs (66,(72)(73)(74)76) , at baseline only in three RCTs (67,71,75) and four RCTs provided no data (68)(69)(70)72) . ...
Article
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Background: The first British Dietetic Association (BDA) guidelines for the dietary management of irritable bowel syndrome (IBS) in adults were published in 2012. Subsequently, there has been a wealth of new research. The aim of this work was to systematically review the evidence for the role of diet in the management of IBS and to update the guidelines. Methods: Twelve questions relating to diet and IBS were defined based on review of the previous guideline questions, current evidence and clinical practice. Chosen topics were on healthy eating and lifestyle (alcohol, caffeine, spicy food, elimination diets, fat and fluid intakes and dietary habits), milk and dairy, dietary fibre, fermentable carbohydrates, gluten, probiotics and elimination diets/food hypersensitivity. Data sources were CINAHL, Cochrane Register of Controlled Trials, Embase, Medline, Scopus and Web of Science up to October 2015. Studies were assessed independently in duplicate using risk of bias tools specific to each included study based on inclusion and exclusion criteria for each question. National Health and Medical Research Council grading evidence levels were used to develop evidence statements and recommendations, in accordance with Practice-based Evidence in Nutrition Global protocol used by the BDA. Results: Eighty-six studies were critically appraised to generate 46 evidence statements, 15 clinical recommendations and four research recommendations. The IBS dietary algorithm was simplified to first-line (healthy eating, provided by any healthcare professional) and second-line [low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) to be provided by dietitian] dietary advice. Conclusions: These guidelines provide updated comprehensive evidence-based details to achieve the successful dietary management of IBS in adults.
... ALA has certain anti-inflammatory and mortality of cardiovascular disease. In original study properties, which can affect independently of lipid by Tarpila et al. [47] were indicated the significance of metabolism. A recent recommendation has suggested that fiber composes in eating diet, such as, lignified fibers. ...
... The main problem is the ratio association between the risk of acute coronary events and of ALA to LA, which ought to support ALA. There are dietary fiber intake [47]. many sources of ALA were recommended by the European population ground flaxseed, canola oil and Cholesterol: High blood cholesterol levels can lead to green leafy vegetables [38,39]. ...
Article
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Flaxseed (Linum usitatissimum) is an oilseed that used in industrial and natural health products. It is used as a food material, animal feed and for decoration purposes. After harvesting, the seeds are often used as animal feed, ground up for fertilizer or even discarded in spite of having very nutritious and best quality oil and the rich source of protein. Flaxseed is rich in nutrients such as proteins, omega 3 fatty acids and especially alpha-linolenic acid (ALA), minerals, fibres and antioxidants. Omega-3 fatty acid has been associated with many physiological functions in the human body. Flaxseed is a great source of dietary fibre which is beneficial for controlling diabetes mellitus and digestive system with higher benefits of polyunsaturated fatty acids, phenolic compounds, gluten-free protein, vitamin, minerals. Therapeutic effects of flaxseed in the control of diabetes, hypertension, dyslipidaemia, also, as anti-inflammatory, laxative, antioxidant, antianxiety, anti-blood clotting, antidepressant, vision, analgesic and immune improver are scientifically established.
... The dietary fiber of flaxseed significantly exhibited positive effects on constipation, shortened the start time of defecation and increased small intestine transit rate and stool frequency (15,16). Flaxseed demonstrated laxative influence in both healthy subjects and the ones with constipation (17)(18)(19). ...
... There were previous clinical reports for usage of flaxseed in treatment of constipation. Tarpila et al. (19) showed that after the period of three months treatment with flaxseed, constipation and abdominal symptoms of patients with irritable bowel syndrome significantly reduced. Safety laboratory values were unchanged with exception of serum thiocyanate and blood cadmium. ...
Article
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Background: Constipation is a common gastrointestinal problem worldwide. Objectives: The current study aimed to prepare a dosage form containing flaxseed and figs and evaluate the effects of this drug to treat functional constipation. Methods: A total of 10 formulations were developed using various proportions of excipients by wet granulation method. The best formulation containing 300 mg flaxseed powder and 1200 mg figs extract (total weight of 2000 mg) was selected. After compression of caplets, evaluation tests such as general appearance, hardness, thickness, weight variation, friability, disintegration time and standardization studies were performed. During clinical study, 15 patients with functional constipation received the prepared dosage form three times daily for two weeks, and then statistical differences within the groups were compared. Results: After the first week of experiment the increase of defecation frequency and reduction of retentive posturing, large fecal mass, pain feeling during evacuation and consistency of stool were significantly noticeable (P < 0.05). Conclusions: Prepared caplets of Linum and Ficus reduced the severity of constipation in patients.
... The dietary fiber of flaxseed significantly exhibited positive effects on constipation, shortened the start time of defecation and increased small intestine transit rate and stool frequency (15,16). Flaxseed demonstrated laxative influence in both healthy subjects and the ones with constipation (17)(18)(19). and discomfort effort for evacuation and the sense of incomplete evacuation (20). ...
... There were previous clinical reports for usage of flaxseed in treatment of constipation. Tarpila et al. (19) showed that after the period of three months treatment Jundishapur J Nat Pharm Prod. In press(In press):e40069. ...
... Flaxseeds display beneficial effects in functional gastrointestinal diseases such as irritable bowel syndrome (IBS) and colitis [37], and have a laxative effect in both healthy [37,38] and constipated individuals [39], but there are only a small number of controlled trials. Xu et al [12] assessed whether PDFM in the intestine also produces short-chain fatty acids such as acetate, propionate and butyrate [40]. ...
Article
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Flaxseeds are a signifcant dietary source of α-linolenic acid, dietary fbre and lignans. The aim of this review is to describe current knowledge concerning the therapeutic and physiological effects of dietary flaxseeds on the gastrointestinal system. We reviewed in vitro, in vivo and clinical studies published between 1976 and 2016 and examining the gastrointestinal activity of lignans, omega-3 fatty acids and fbre in dietary flaxseeds. We searched PubMed/MEDLINE using the keywords ‘lignans’, ‘flaxseeds’, ‘fbre’, ‘omega 3 fatty acids’ and ‘gastrointestinal’ alone or combined. The results indicate that flaxseed lignans and omega-3 fatty acids may be effective for preventing and reducing colon cancer, modulating constipation and diarrhoea through the synergic activity of lignans, fbre and omega-3 fatty acids, and reducing bowel inflammation through downregulation by omega-3 fatty acids of the expression of pro-inflammatory cytokines. In addition, a positive effect on the gut microbiota has been observed both in experimental in vivo studies and in clinical trials, probably through lignan activity, although the exact mechanism of action has not been elucidated. Our review suggests dietary flaxseeds may have benefcial effects on the gastrointestinal system.
... Formula 1 while convincing data were lacking, soluble fiber did appear to be beneficial to global symptom improvement while insoluble fiber was not. 25 In small, albeit not necessarily well-designed studies, partially hydrolyzed guar gum, psyllium, ispaghula, and flax seed [25][26][27] have shown benefit in people with IBS. Of course, fiber use requires an increase in water intake, which also helps overcome constipation. ...
Article
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Botanicals are a useful primary therapy for patients with irritable bowel syndrome (IBS). This article reviews categories of herbs that are useful in treating IBS and suggests how they can be combined in individual IBS formulas. The categories of herbs discussed are bitters, cholagogues, hepatorestoratives, carminatives, antispasmodics, anti-inflammatories, antimicrobials, antidiarrheals, aperients, nervines, and adaptogens. The herbs discussed are peppermint (Mentha x piperita), bitter candytuft (Iberis amara), artichoke (Cynara scolymus) leaf, fumitory (Fumaria officinalis), dandelion (Taraxacum officinalis), celandine (Chelidonium majus), fringetree (Chionanthus virginicus), schisandra (Schisandra chinensis), caraway (Carum carvi), German chamomile flower (Matricaria recutita), wild yam (Dioscorea villosa), crampbark (Viburnum spp.), Oregon grape (Mahonia aquifolium), psyllium (Plantago spp.) seed, valerian (Valeriana officinalis), and lemon balm (Melissa officinalis).
... Also, Sairanen et al. [34] reported an improvement of chronic constipation in elderly subjects receiving a probiotic yogurt containing also 12 g of galacto-oligosaccharides (GOS), 12 g of prunes and 6 g of linseed, although in this case it is not easy to ascertain the effects of linseed from those of prunes, GOS or probiotic bacteria. Ground and partially defatted linseed proved to be efficacious, when administered, in reducing constipation and abdominal symptoms in patients affected by inflammatory bowel syndrome [35]. ...
Article
Chronic constipation is a widespread pathology resulting in a very low frequency of evacuation, and defecation can be also very difficult. In addition to colo-rectal cancer or pelvic floor disfunction, stipsi can be determined by low fibre intake. In our experiment, we tested the efficacy of a linseed-based snack on the defecation frequency in a cohort affected by stipsi. Enrolled people received for 21 days a high fibre and linseed-based snack (30 g)—the severity of constipation was evaluated with the Constipation Scoring System (CSS) determined at the beginning and at the end of the experiment. The consumption of this biscuit significantly increased defecation frequency and reduced difficult or incomplete evacuation. As a consequence of this improvement, the CSS was significantly reduced: 9.19 vs. 4.52. No adverse effects, due to the consumption of the tested snack, were observed.
... Flaxseed has a potential to increase laxation due to highdietary fiber content, which absorbs water and increase intestinal bulk (Cunnane et al., 1995) and thus play an important role in preventing and curing constipation condition. Feeding trials of roughly ground partly defatted flaxseed to patients suffering from constipation predominant irritable bowel syndrome showed a significant reduction in constipation and abdominal symptoms (Tarpila et al., 2004). Muir et al. (1999) showed that the addition of SDG at 15 mg/kg of rabbits resulted in 33% reduction in atherosclerotic plaques on a high cholesterol Downloaded by [${individualUser.displayName}] at 01:53 12 February 2014 diet compared to control subjects on a high cholesterol diets alone. ...
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... In a clinical study by Tarpila et al. (2004), the blood cadmium of patients remained unchanged after six months of linseed treatment, and ground flaxseed was considered safe at a daily dose of up to 24 g. According to Morris (2003), a daily dose of 30 g of linseed is optimal for utilization of functional components as fatty acids. ...
Article
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The aim of this study was to screen the cadmium (Cd) contents of seed and seed crush of Finnish linseed and to evaluate the acceptable daily dose. The Cd content of Finnish linseed is of interest, since some prop-erties of linseed as the content of fatty acids are different in northern growth locations compared with other growing areas. Seed samples (N = 85) were collected from the experimental farm of Helsinki University and from commercial fields in different locations in southern Finland and Ostrobothnia. In addition, 15 samples of linseed crush were examined. The cadmium contents of the linseed samples, determined with atomic absorption spectroscopy, varied between 0.27 and 1.3 mg kg -1 (dry weight) (mean 0.61 mg kg -1). The Cd contents of the crush samples were between 0.47 and 1.5 mg kg -1 (mean 0.85 mg kg -1). There were dif-ferences between the Cd contents of the three examined varieties and years at the experimental farm. In-crease in nitrogen fertilization somewhat increased the Cd uptake of linseed. The permitted intake of lin-seed depends on body weight and on the Cd content of the product and is in most cases higher than the di-etary recommendation (24–30 g daily dose of linseed).
... The cadmium content of a flaxseed product investigated was analyzed to be 0.84 mg/kg. [33] Cadmium accumulates in the liver and kidneys, where the proteins called metallothioneins bind it. The amount of these proteins increases after cadmium exposure. ...
... Flaxseed exists in several main forms such as whole seed, ground seed and partially defatted flaxseed meal (PDFM), and PDFM contains the highest content of dietary fibers in common forms of flaxseed [7]. Some investigations had shown that flaxseed exhibited the similar laxative actions in healthy [8,9] and constipated subjects [10], whereas the relevant controlled trials are rare. In the present study, we tried to assess that whether PDFM has the potential role to facilitate fecal output in normal and experimental constipated mice. ...
Article
Full-text available
Constipation is a very common health problem in the world. Intake of sufficient amount of dietary fibers is a cornerstone in the prevention and treatment of constipation. As a traditional medicine, flaxseed has been used to treat constipation for centuries, but the controlled trials are rare. The purpose of the present study was to assess that whether partially defatted flaxseed meal (PDFM) has the potential role to facilitate fecal output in normal and experimental constipated mice. After supplemented with 2.5%, 5% and 10% (w/w) PDFM (L-, M- and H-PDFM) for 14 days, the constipation models of mice were induced by atropine-diphenoxylate. The small intestinal transit rates, start time of defecation, amount of defecation and wet weight of feces were researched in normal and constipation model mice. M- and H-PDFM significantly increase small intestinal transit rates in constipation model mice. All dose of PDFM markedly shortened the start time of defecation and M- and H-PDFM significantly increase stool frequency and weight in both normal and constipation model mice. PDFM may be a useful laxative to facilitate fecal output in normal and constipation conditions.
... These effects are attributed to the bulk materials and in particular to the mucilage that binds with water and swells to form a demulcent gel in the intestine (Schilcher et al., 1986;Wirths et al., 1985;Schulz et al., 1983). In a randomised investigator-blinded trial with two parallel treatment groups, 55 patients suffering from constipation predominant irritable bowel syndrome received 6 -24 g/d either flaxseed (roughly ground partly defatted) or psyllium seed for 3 months (Tarpila et al., 2004). The recommended dosage as a laxative for adults, elderly and adolescents over 12 years of age (10 -15 g, 2 -3 times daily) is supported by general evidence and by clinical investigations (Schilcher et al., 1986;Willuhn, 1989). ...
... After the blinding period, 40 out of 55 patients continued in an open period of further 3 months with only flaxseed treatment and constipation and abdominal symptoms were further reduced. (Tarpila et al. 2003). ...
Chapter
This chapter presents clinical and pre-clinical evidence, indications, mechanisms of action, potential interactions, contraindications, and possible adverse effects of the herbal medicine, Linseed or Flaxseed (Linum usitatissimum L.). Traditional linseed extracts are often mucilaginous preparations, used as demulcents; they are taken internally for the symptomatic relief of constipation, gastrointestinal discomfort, bronchitis and coughs, and applied externally as a soothing emollient agent for burns. Flaxseed oil is available in capsules as a food supplement, as a source of omega-3 essential fatty acids and phytoestrogens. Linseeds and linseed flour are used as an ingredient of functional foods (such as bread) where the phytoestrogenic properties of the lignans are intended to help to alleviate menopausal symptoms. Flax is widely cultivated in Europe, North- and South-America and also used for the production of linen from the fibres.
... Psyllium does not contain any oil. (Tarpila et al., 2004) In a other study Jiqu et al., (2012) investigate the Laxative effects of partially defatted flaxseed meal on normal and experimental constipated mice, and concluded that partially defatted flaxseed meal has the ability to promote intestinal motility, stimulate intestinal transit as well as increase stool frequency and weight. And suggested that partially defatted flaxseed meal may be a usefull laxative to facilitate fecal output in normal and constipation condition, ...
Article
of Tukhm-e-Katan (Linum usitatissimum L.). Int J Adv Pharm Med Bioallied Sci. 2017; 2017:111.
... Although not powered to do so, the present study investigated the relationship between FAST symptoms and the consumption of fiber and FODMAPs within that meal. Although fiber has traditionally been effective in treating constipation, studies have found that fiber may worsen gastrointestinal symptoms (17,(45)(46)(47). Higher fiber intake at a meal was associated with abdominal fullness, with participants with IBS-C experiencing moderate correlations between fiber intake and the duration of abdominal fullness and bloating. ...
Article
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Introduction: Patients with irritable bowel syndrome (IBS) identify food as a trigger for the onset or worsening of gastrointestinal symptoms. Despite this, there is no published validated contemporaneous food and symptom diary to investigate the association between diet and IBS symptoms. The objective of this prospective observational study was to assess the construct validity of a novel food diary and symptom questionnaire, the Food and Symptom Times (FAST) diary, and the predictive validity of the food diary component with relation to fiber and fermentable oligosaccharides, disaccharides, monosaccharides, and polyols consumption and subsequent gastrointestinal symptoms. Methods: Fifty-one participants with IBS completed the FAST diary and several legacy instruments. The relationship between the FAST gastroenterological symptoms and legacy instruments was examined using Spearman correlation coefficients. Further statistical analysis investigated the relationship between diet and postprandial gastrointestinal symptoms. Results: Consistent with a priori predictions, the FAST symptoms showed moderate correlations with the most similar Patient-Reported Outcome Measurement Information System gastrointestinal scales (0.328-0.483, P < 0.05) and the most similar Gastrointestinal Symptom Rating Scale questions (0.303-0.453, P < 0.05), with the exception of the weakly correlated subscale constipation for both instruments (-0.050 to -0.119, P > 0.05). The IBS-Quality of Life instrument showed moderate correlations with the FAST symptom abdominal swelling/distension (0.313-0.416, P < 0.05). The consumption of a high fermentable oligosaccharides, disaccharides, monosaccharides, and polyols meal was associated with participants with IBS-D experiencing abdominal bloating and participants with IBS-C not experiencing abdominal swelling (P < 0.05). The consumption of fiber was correlated with abdominal fullness and bloating in participants with IBS-C (P < 0.05). Discussion: The FAST diary validly measures gastrointestinal symptoms as they occur in people with IBS and correlates these symptoms with specific aspects of diet.
... Information is provided on reducing resistant starches, based on evidence that high intakes can cause symptoms in healthy individuals (Muir et al., 2004;Storey et al., 2007), although there is a lack of randomised controlled data. In addition, the resource provides information on addition of linseeds, which may improve constipation and abdominal symptoms (Tarpila et al., 2004) and the use of probiotics. These resources are available from NICE and are widely used across the UK. ...
Article
Emerging evidence indicates that the consumption of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) may result in symptoms in some patients with irritable bowel syndrome (IBS). The present study aimed to determine whether a low FODMAP diet is effective for symptom control in patients with IBS and to compare its effects with those of standard dietary advice based on the UK National Institute for Health and Clinical Excellence (NICE) guidelines. Consecutive patients with IBS who attended a follow-up dietetic outpatient visit for dietary management of their symptoms were included. Questionnaires were completed for patients who received standard (n = 39) or low FODMAP dietary advice (n = 43). Data were recorded on symptom change and comparisons were made between groups. In total, more patients in the low FODMAP group reported satisfaction with their symptom response (76%) compared to the standard group (54%, P = 0.038). Composite symptom score data showed better overall symptom response in the low FODMAP group (86%) compared to the standard group (49%, P < 0.001). Significantly more patients in the low FODMAP group compared to the standard group reported improvements in bloating (low FODMAP 82% versus standard 49%, P = 0.002), abdominal pain (low FODMAP 85% versus standard 61%, P = 0.023) and flatulence (low FODMAP 87% versus standard 50%, P = 0.001). A low FODMAP diet appears to be more effective than standard dietary advice for symptom control in IBS.
... 18 Several studies have shown that flaxseed has similar laxative properties in healthy 19,20 and constipated individuals. 21 However, to our knowledge, there have been no randomized controlled trials testing the efficacy of flaxseed supplementation in subjects with functional constipation. ...
Article
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Background and objectives: This prospective, randomized, controlled study aimed to evaluate the effects of flaxseed supplementation on functional constipation and quality of life in adult men and women in China. Methods and study design: 90 subjects with functional constipation diagnosed by the Rome IV criteria were enrolled. Subjects were randomly assigned to receive either 50 g/day flaxseed flour with meals (n=60) or 15 mL/day of a lactulose solution on an empty stomach (n=30) every morning for 4 weeks. Wexner constipation scores, stool consistency according to the Bristol Stool Form Scale, and bowel habits (frequency of bowel movements/week, the time spent on defecation) were the primary outcomes. The change in Patient Assessment of Constipation Quality of Life score was the secondary outcome. Results: After 4 weeks, the bowel habits in both groups were significantly improved. The median Wexner constipation score decreased from 14 to 6.5 in the flaxseed group (p<0.001) and from 15 to 9 in the lactulose group (p<0.001). The median defecation frequency per week increased significantly (2 to 7 for flaxseed and 2 to 6 for lactulose, p<0.001 for both groups). The Patient Assessment of Constipation Quality of Life score decreased significantly (-1.34 and -0.66 for flaxseed and lactulose, respectively; p<0.001 for both groups). Conclusions: Flaxseed flour is somewhat more effective at increasing defecation frequency than lactulose, improving bowel movements and promoting life quality of subjects with chronic functional constipation in the Chinese population.
... Flaxseed has a potential to increase laxation due to highdietary fiber content, which absorbs water and increase intestinal bulk (Cunnane et al., 1995) and thus play an important role in preventing and curing constipation condition. Feeding trials of roughly ground partly defatted flaxseed to patients suffering from constipation predominant irritable bowel syndrome showed a significant reduction in constipation and abdominal symptoms (Tarpila et al., 2004). Muir et al. (1999) showed that the addition of SDG at 15 mg/kg of rabbits resulted in 33% reduction in atherosclerotic plaques on a high cholesterol Downloaded by [National Dairy Research Inst -I C A R] at 21:21 19 June 2014 diet compared to control subjects on a high cholesterol diets alone. ...
Article
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Flaxseed is one of the most important oilseed crops for industrial as well as food, feed, and fiber purposes. Almost every part of the flaxseed plant is utilized commercially, either directly or after processing. The stem yields good quality fiber having high strength and durability. The seed provides oil rich in omega-3, digestible proteins, and lignans. In addition to being one of the richest sources of α-linolenic acid oil and lignans, flaxseed is an essential source of high quality protein and soluble fiber and has considerable potential as a source of phenolic compounds. Flaxseed is emerging as an important functional food ingredient because of its rich contents of α-linolenic acid (ALA), lignans, and fiber. Lignans appear to be anti-carcinogenic compounds. The omega-3s and lignan phytoestrogens of flaxseed are in focus for their benefits for a wide range of health conditions and may possess chemo-protective properties in animals and humans. This paper presents a review of literature on the nutritional composition of flaxseed, its health benefits, and disease-prevention qualities, utilization of flaxseed for food, feed, and fiber, and processing of flaxseed.
... (84) Positive effects were also encountered in patients with irritable bowel syndrome who received 17 g of flaxseed per day during 3 months, demonstrating a reduction in constipation and in other abdominal symptoms. (85) In summary, the ingestion of 30 g of flaxseed per day, which is a quantity utilized in some studies with humans, provides a considerable quantity of the bioactive compounds studied, being efficient to supply the dosages used in the majority of the studies. ...
Article
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Consumption of flaxseed has been increased due to its possible functional properties in health. However, its chronic consumption may offer risks considering the effects of lignans in men and in pregnant women, as well as the existence of other phytochemicals and toxic factors with adverse health effects in the seed. The present review focuses on the growing body of evidence on the potential health benefits of flaxseed in humans, with supporting evidence from human and animal studies. It also raises questions that provide input for future research on the effects of flaxseed ingestion in terms of nutrient bioavailability and human fertility.
Article
Objective: To conduct a systematic literature review to assess burden of disease and unmet medical needs in patients with irritable bowel syndrome (IBS) with constipation (IBS-C), with a focus on five European countries (France, Germany, Italy, Spain, UK). Methods: MEDLINE, EMBASE, and grey literature searches were carried out using terms for IBS and constipation, to identify studies reporting epidemiological, clinical, humanistic, or economic outcomes for IBS-C, published between 2000 and 2010. Results: Searches identified 885 unique abstracts and 33 supplementary articles, of which 100 publications and six grey literature sources met the inclusion criteria. Among patients with IBS, the prevalence estimates of IBS-C ranged from 1 to 44%. Co-morbid conditions, such as personality traits, psychological distress, and stress, were common. Patients with IBS-C had lower health-related quality-of-life (HRQoL) compared with the general population, and clinical trials suggested that effectively treating IBS-C improves HRQoL. The European societal cost of IBS-C is largely unknown, as no IBS-C-specific European cost-of-illness studies were identified. Two cost analyses demonstrated the substantial societal impact of IBS-C, including reduced productivity at work and work absenteeism. Guidelines offered similar recommendations for the diagnosis and management of IBS; however, recommendations specifically for IBS-C varied by country. Current IBS-C treatment options have limited efficacy and the risk:benefit profile of early 5-HT(4) agonists restricts clinical use. Conclusions: This systematic review indicates a clear need for European-focused IBS-C burden-of-disease and cost-of-illness studies to address identified evidence gaps. There is a need for new therapies for IBS-C that are effective, well tolerated, and have a positive impact on HRQoL.
Article
Background: Manipulation of dietary fibre intake represents a longstanding treatment for patients with irritable bowel syndrome (IBS), particularly for those with constipation. Linseeds are often recommended by both clinicians and dietitians as a source of dietary fibre to alleviate symptoms. Recent guidance on the management of irritable bowel syndrome (IBS) advises that linseeds may reduce wind and bloating, although there is limited clinical evidence to support this recommendation. The present pilot study aimed to compare the clinical effectiveness of: (i) whole linseeds versus ground linseeds; (ii) whole linseeds versus no linseeds; and (iii) ground linseeds versus no linseeds in the management of IBS symptoms. Methods: In an open randomised controlled trial, subjects with IBS (n = 40) were allocated to one of three intervention groups: two tablespoons of whole linseeds per day (n = 14), two tablespoons of ground linseeds per day (n = 13) and no linseeds as controls (n = 13). Symptom severity (primary outcome) and bowel habit were assessed before and after a 4-week intervention and statistical differences between the groups were compared. Results: Thirty-one subjects completed the present study. Between-group analysis comparing the improvement in symptom severity did not reach statistical significance for whole linseeds (n = 11) versus ground linseeds (n = 11; P = 0.62), whole linseeds versus controls (n = 9; P = 0.12) and ground linseeds versus controls (P = 0.10). There were no significant changes in stool frequency or stool consistency for any of the groups. Conclusions: Linseeds may be useful in relief of IBS symptoms. Further research is needed to detect clear differences between the effects of whole and ground linseeds.
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Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder. The role of pharmacotherapy for IBS is limited and focused mainly on symptom control. The objective of this systematic review was to evaluate the efficacy of bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Computer assisted structured searches of MEDLINE, EMBASE, The Cochrane library, CINAHL and PsychInfo were conducted for the years 1966-2009. An updated search in April 2011 identified 10 studies which will be considered for inclusion in a future update of this review. Randomized controlled trials comparing bulking agents, antispasmodics or antidepressants with a placebo treatment in patients with irritable bowel syndrome aged over 12 years were considered for inclusion. Only studies published as full papers were included. Studies were not excluded on the basis of language. The primary outcome had to include improvement of abdominal pain, global assessment or symptom score. Two authors independently extracted data from the selected studies. Risk Ratios (RR) and Standardized Mean Differences (SMD) with 95% confidence intervals (CI) were calculated. A proof of practice analysis was conducted including sub-group analyses for different types of bulking agents, spasmolytic agents or antidepressant medication. This was followed by a proof of principle analysis where only the studies with adequate allocation concealment were included. A total of 56 studies (3725 patients) were included in this review. These included 12 studies of bulking agents (621 patients), 29 of antispasmodics (2333 patients), and 15 of antidepressants (922 patients). The risk of bias was low for most items. However, selection bias is unclear for many of the included studies because the methods used for randomization and allocation concealment were not described. No beneficial effect for bulking agents over placebo was found for improvement of abdominal pain (4 studies; 186 patients; SMD 0.03; 95% CI -0.34 to 0.40; P = 0.87), global assessment (11 studies; 565 patients; RR 1.10; 95% CI 0.91 to 1.33; P = 0.32) or symptom score (3 studies; 126 patients SMD -0.00; 95% CI -0.43 to 0.43; P = 1.00). Subgroup analyses for insoluble and soluble fibres also showed no statistically significant benefit. Separate analysis of the studies with adequate concealment of allocation did not change these results. There was a beneficial effect for antispasmodics over placebo for improvement of abdominal pain (58% of antispasmodic patients improved compared to 46% of placebo; 13 studies; 1392 patients; RR 1.32; 95% CI 1.12 to 1.55; P < 0.001; NNT = 7), global assessment (57% of antispasmodic patients improved compared to 39% of placebo; 22 studies; 1983 patients; RR 1.49; 95% CI 1.25 to 1.77; P < 0.0001; NNT = 5) and symptom score (37% of antispasmodic patients improved compared to 22% of placebo; 4 studies; 586 patients; RR 1.86; 95% CI 1.26 to 2.76; P < 0.01; NNT = 3). Subgroup analyses for different types of antispasmodics found statistically significant benefits for cimteropium/ dicyclomine, peppermint oil, pinaverium and trimebutine. Separate analysis of the studies with adequate allocation concealment found a significant benefit for improvement of abdominal pain. There was a beneficial effect for antidepressants over placebo for improvement of abdominal pain (54% of antidepressants patients improved compared to 37% of placebo; 8 studies; 517 patients; RR 1.49; 95% CI 1.05 to 2.12; P = 0.03; NNT = 5), global assessment (59% of antidepressants patients improved compared to 39% of placebo; 11 studies; 750 patients; RR 1.57; 95% CI 1.23 to 2.00; P < 0.001; NNT = 4) and symptom score (53% of antidepressants patients improved compared to 26% of placebo; 3 studies; 159 patients; RR 1.99; 95% CI 1.32 to 2.99; P = 0.001; NNT = 4). Subgroup analyses showed a statistically significant benefit for selective serotonin releasing inhibitors (SSRIs) for improvement of global assessment and for tricyclic antidepressants (TCAs) for improvement of abdominal pain and symptom score. Separate analysis of studies with adequate allocation concealment found a significant benefit for improvement of symptom score and global assessment. Adverse events were not assessed as an outcome in this review. There is no evidence that bulking agents are effective for treating IBS. There is evidence that antispasmodics are effective for the treatment of IBS. The individual subgroups which are effective include: cimetropium/dicyclomine, peppermint oil, pinaverium and trimebutine. There is good evidence that antidepressants are effective for the treatment of IBS. The subgroup analyses for SSRIs and TCAs are unequivocal and their effectiveness may depend on the individual patient. Future research should use rigorous methodology and valid outcome measures.
Article
  This paper describes the effect of flaxseed on two bread formulations. The quality of bread rolls—containing flaxseed—and the quality of cinnamon rolls—containing flaxseed and flaxseed oil—is determined by sensory evaluation (texture, odor, and flavor), instrumental texture measurement and chemical analysis (fatty acids, fiber, secoisolarisiresinol diglycoside, and cadmium). Bread aging is monitored by measuring sensory attributes during storage. The results indicate that the flaxseed rolls retain moisture and softness more efficiently than the control rolls that do not contain flaxseed. No off-odors were detected during the storage period from 0 to 6 d at room temperature (+22 °C), although flaxseed rolls and cinnamon rolls were discovered to be high in unsaturated fats. The major fatty acid in both bakery samples that contained flaxseed was α-linolenic acid. The flaxseed rolls were also high in fiber. Therefore, from a nutritional viewpoint flaxseed shows beneficial properties in breadmaking. It has a positive impact on the texture parameters during storage as well as on the nutritional composition, for example, the content of fiber and unsaturated fats.
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Constipation is common health problem of youngsters and their cure is possible through change in food habits. Inclusion of dietary fibers in the diet reduces the constipation and its complications like overweight, cancer etc. The main objective of the present study is to evaluate the effect of fibers present in a mixture of wheat bran, coriander seeds, drumstick and flaxseed toward curing constipation. The total forty subjects male and female of age between 20-30 years were selected from PG Hostel, OUAT, Bhubaneswar for this study and all were sufferer of constipation at the stage of mild to severe. The result shows reduction of constipation patients by 80% in 20-25 year male and 100% in 20-25 year female, 25-30 year male and female after supplementation of a mixture of Flaxseed, Coriander, Wheat Bran, and Drumstick (ratio of 1.5,3.0,5.5,0 and1.5,2.5,4.0,2.0) to the diet after completion of the study. Thus inclusion of these fibers in the regular diet is suggested to overcome constipation in human beings.
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The theme of infanticide has been seen as a prominant factor in all these works . I have applied this theme in my five works I have studied. These works cover the anglo american literature from 1859 to 1987.the works are George Eliot's Adam Bede,Eugene O'Neill's Desire Under the Elms,Edward Albee's The American Dream,Sam Shepard's The Buried Child and Toni Morrison's Beloved. The causes for the murder of infant range from shame of being shunned by the society,anger,lunacy , protection etc.The author's backgrounds also reveal a world of deranged families ,the search for love which made them write the following works.
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The chapter discusses lactose, non-starch polysaccharides (NSP), caffeine, alcohol, fat, resistant starch, fermentable carbohydrates and gluten, which are target for dietary intervention in Irritable bowel syndrome (IBS). The use of food-specific IgG antibody concentration as a diagnostic tool for identifying culprit foods in food allergy or any other adverse food reaction has been investigated. Pharmacological food intolerance may contribute to gastrointestinal symptoms. The chapter describes various types of exclusion diets for the management of IBS. The numerous clinical trials investigates the therapeutic benefit of probiotics in IBS with heterogeneity in dosing regimens, species used and clinical end-points. There have been very few trials of prebiotics in IBS. A number of dietary components have been reported to trigger symptoms in IBS.
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The use of flaxseed as a dietary supplement is increasing in parallel with the research on its multitudinous effects on human health. Water-binding capacity of flaxseed insoluble fiber increases the intestinal bulk which is useful in the treatment of constipation, irritable bowel syndrome and diverticular disease. Soluble fiber from flaxseed mucilage delays gastric emptying, improves glycemic control, alleviates constipation and reduces serum cholesterol. Epidemiological studies show that the intake of dietary fiber and colorectal cancer correlate inversely. Flaxseed lignans and fatty acids have been investigated in several cohort studies for their effects on breast cancer risk and there is an association between elevated serum enterolactone and decreased incidence of breast cancer. The flaxseed diet has been shown to be beneficial on prostate cancer and benign prostate hyperplasia when defined by cell proliferation indexes and other cancer biomarkers. Alpha-linolenic acid seems to have an antiproliferative effect on prostate cancer cells. Elevated serum enterolactone level associates with a lower incidence of acute coronary heart disease. Respectively, low serum enterolactone enhances the risk for coronary deaths. Alpha-linolenic acid has been shown protective against cerebrovascular stroke and atherogenic carotid plaque formation. This article reviews health aspects of dietary flaxseed in light of current scientific research.
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The aims of nutritional management are to advise on dietary modifications that may help to improve symptom severity, without jeopardising the overall quality of the patients diet. This chapter discusses current evidence based practice and presents some possible dietary treatments options for patients experiencing bowel dysfunction.
Article
Objective:To evaluate the effects of flaxseed consumption in changing the lipid profile, cancer control and hormone replacement therapy at menopause and andropause in individuals of all ages. Materials and methods:We conducted a systematic review of randomized controlled trials that examined the effects of flaxseed consumption on body weight reduction, change in blood lipid levels, cancer control and menopausal symptoms. We used Pub-Med, Lilacs, the libraries of PAHO and WHO, and clinical trials published in Cochrane between January 1, 2000 and June 30, 2010. The articles that met the inclusion criteria were assessed for methodological quality. Results: We included 49 articles. Studies reported that flaxseed consumption generates small changes in blood lipid concentrations, improvement in menopausal symptoms, promotes the reduction of tumor proliferation rates and increased apoptosis in breast and prostate cancer. Conclusions: The results are not yet sufficient to recommend the use of flaxseed for the control of hypercholesterolemia in patients with dyslipidemia. The evidence favors flaxseed as an alternative adjuvant therapy for breast and prostate cancer treatment, and reduction of menopause symptoms.
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This chapter discusses the ethnopharmacological properties, phytochemistry, and culture conditions of the Linum species. Flax fibers of Linum usitatissimum are separated from the shoots of this crop plant and are stronger than cotton fibers. Flaxseed is used in treatment of cardiac disorders, cancer, arthritis, wounds, abscesses, diabetes, and digestive disorders. The formulated products of flaxseed have gastroprotective effects and possess, inter alia, antibacterial, radioprotective, and nephroprotective properties. The presence of ellagic acid, catechin, chlorogenic acid, gallic acid, kaempferol, umbelliferone, caffeic acid, coumaric acid, epicatechin, and rutin in L. usitatissimum has also been determined by ultra‐performance liquid chromatography in six flaxseed cultivars. The suspension cultures of L. mucronatum were induced in darkness at 25∘C and analyzed for estimation of lignans. During the course of estimation, the 6‐methoxypodophyllotoxin was found as a major compound and its identity confirmed by spectral data analysis.
Chapter
Flaxseed is an important crop being used for multiple purposes with increasing applications in functional food development because of its high content of bioactive fatty acids (omega-3) and other phytonutrients. It contains several biologically active components that prevent and cure several physiological conditions and noncommunicable diseases such as dyslipidemia, obesity, diabetes mellitus, several types of cancer, kidney and renal failure, bowel syndrome, immune functions, etc. Flaxseed products such as whole seed, meal, oil, or mucilage are predominantly used for functional food development. In the present chapter, the proximates composition, mechanisms involved in the health benefits, and the effect of flaxseed on the quality of different food products have been discussed.
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Dietary fiber can affect cadmium (Cd) absorption and toxicity, but the effect appears to depend on the type of dietary fiber. The aim of the present study was to compare the effect of dietary sources containing distinct amounts of soluble and insoluble fiber on Cd absorption, accumulation and toxicity in growing rats. The absorption of essential macrominerals (Ca, P and Mg) was also evaluated. Animals received a nutritionally balanced diet with cellulose (cel - control), wheat bran or flaxseed as the fiber source with 0 or 50 mg Cd kg(-1) diet, during 30 days. Cd exposure reduced body weight gain, feed efficiency ratio, epididymal fat relative weight and liver relative weight, and increased plasma alanine aminotransferase activity in all fiber groups. The apparent Cd absorption was similar among Cd-groups, but the flax-Cd group had a higher hepatic and renal Cd concentration. Cd decreased the absorption of Ca and P, and increased Mg absorption in the wheat bran and flaxseed groups, but not in the cel group. Although the different fiber sources investigated had no effect on Cd toxicity, the major soluble fiber source, flaxseed, increased Cd retention. Thus, caution should be taken in the intake of flaxseed by Cd-exposed populations.
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An improved spectrophotometric method is described for the determination of thiocyanate in plasma and urine. Thiocyanate is adsorbed on a weak anion-exchange resin with strong affinity for chaotropic ions, and eluted with perchlorate. Thiocyanate is then chlorinated by hypochlorite and quantified according to the König (J Prakt Chem 1904; 69:105-37) reaction by use of isonicotinic acid and 1,3-dimethyl-barbituric acid. The method affords a simple, rapid and sensitive assay for thiocyanate and has a detection limit of 0.93 mumol/l. At thiocyanate concentrations of 107.1 and 167.4 mumol/l in plasma and urine the within-day CVs were 0.69% and 1.1% respectively, and the total imprecision measured for a period of 65 days was 0.98%. Analytical recoveries were quantitative both with urine and plasma samples.