Fiber Wars: Are mixed soluble and insoluble fibers the answer for irritable bowel syndrome?

Fiber is known to exert various favorable effects on the gastrointestinal tract via modulation of the microbiota, formation of metabolites (such as short chain fatty acids), altered motility, and manipulation of stool form. While there has been tremendous interest in utilizing fiber in the treatment of irritable bowel syndrome, results have been conflicting, with some studies finding benefit and others finding no effect or even worsening of symptoms. Nopal is a fiber derived from a cactus plant which is predominantly composed of soluble fiber. We summarize the @GIJournal discussion held on April 21, 2021 during which Remes-Troche et al. “Nopal fiber (Opuntia ficus?indica) improves symptoms in irritable bowel syndrome in the short term: a randomized controlled trial” was critically reviewed by our expert Dr. Mark Pimentel (MP), and moderated by Dr. Linda Nguyen (LN).