{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T23:34:41Z","timestamp":1794526481142,"version":"4.9.1"},"reference-count":30,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Gut"],"accepted":{"date-parts":[[2018,7,19]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>More effective treatments are needed for patients with postinfectious, diarrhoea-predominant, irritable bowel syndrome (IBS-D). Accordingly, we conducted a randomised, double-blind, placebo-controlled, 8-week-long trial to assess the efficacy and safety of oral glutamine therapy in patients who developed IBS-D with increased intestinal permeability following an enteric infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eligible adults were randomised to glutamine (5\u2009g\/t.i.d.) or placebo for 8 weeks. The primary end point was a reduction of \u226550 points on the Irritable Bowel Syndrome Severity Scoring System (IBS-SS). Secondary endpoints included: raw IBS-SS scores, changes in daily bowel movement frequency, stool form (Bristol Stool Scale) and intestinal permeability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-four glutamine and 52 placebo subjects completed the 8-week study. The primary endpoint occurred in 43 (79.6%) in the glutamine group and 3 (5.8%) in the placebo group (a 14-fold difference). Glutamine also reduced all secondary endpoint means: IBS-SS score at 8 weeks (301 vs 181, p&lt;0.0001), daily bowel movement frequency (5.4 vs 2.9\u00b11.0, p&lt;0.0001), Bristol Stool Scale (6.5 vs 3.9, p&lt;0.0001) and intestinal permeability (0.11 vs 0.05; p&lt;0.0001). \u2018Intestinal hyperpermeability\u2019 (elevated urinary lactulose\/mannitol ratios) was normalised in the glutamine but not the control group. Adverse events and rates of study-drug discontinuation were low and similar in the two groups. No serious adverse events were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with IBS-D with intestinal hyperpermeability following an enteric infection, oral dietary glutamine supplements dramatically and safely reduced all major IBS-related endpoints. Large randomised clinical trials (RCTs) should now be done to validate these findings, assess quality of life benefits and explore pharmacological mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT201414244\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial results\">NCT1414244<\/jats:ext-link>\n                      ; Results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/gutjnl-2017-315136","type":"journal-article","created":{"date-parts":[[2020,3,28]],"date-time":"2020-03-28T15:15:42Z","timestamp":1585408542000},"page":"996-1002","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":178,"title":["Randomised placebo-controlled trial of dietary glutamine supplements for postinfectious irritable bowel syndrome"],"prefix":"10.1136","volume":"68","clinical-trial-number":[{"clinical-trial-number":"nct1414244","registry":"10.18810\/clinical-trials-gov","type":"results"}],"author":[{"given":"QiQi","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA"},{"name":"Department of Veteran Affairs, Malcom Randall VAMC, Gainesville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan L","family":"Verne","sequence":"additional","affiliation":[{"name":"Health Sciences, Texas A&M University, College Station, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy Z","family":"Fields","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J","family":"Lefante","sequence":"additional","affiliation":[{"name":"Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarpreet","family":"Basra","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habeeb","family":"Salameh","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Texas Medical Branch, Galveston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G Nicholas","family":"Verne","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,8,14]]},"reference":[{"key":"2025090711581352000_68.6.996.1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.14"},{"key":"2025090711581352000_68.6.996.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1207068"},{"key":"2025090711581352000_68.6.996.3","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.08.002"},{"key":"2025090711581352000_68.6.996.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1004409"},{"key":"2025090711581352000_68.6.996.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505180"},{"key":"2025090711581352000_68.6.996.6","first-page":"e1","article-title":"2015 James W. 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