Bran and irritable bowel syndrome: time for reappraisal.

Whilst following up large numbers of patients with irritable bowel syndrome we got the impression that wholemeal wheat and bran products made people with the condition worse rather than better. One hundred consecutive new referrals, all of whom had tried bran, were questioned to resolve this issue. 55% of patients were made worse by bran whereas only 10% had found it helpful. With the exception of fruit, other forms of dietary fibre were not as detrimental and proprietary supplements were found to be beneficial. All symptoms of irritable bowel syndrome were exacerbated by bran, with bowel disturbance most often adversely affected, followed by abdominal distension and pain. The results of this study suggest that the use of bran in irritable bowel syndrome should be reconsidered. The study also raises the possibility that excessive consumption of bran in the community may actually be creating patients with irritable bowel syndrome by exacerbating mild, non-complaining cases.