In de literatuurlijsten niet-toxische stoffen en behandelingen van arts-bioloog drs. Engelbert Valstar wordt L-glutamine ook veelvuldig genoemd als een uitstekend voedingssupplement dat ook naast andere reguliere behandelingen bijwerkingen vermindert en effectiviteit verhoogd meestal. Als donateur kunt u ook korting krijgen op bepaalde voedingssupplementen.

Zie ook wikipedia over Glutamine

17 december 2025: Bron: 2019 Jun;68(6):996-1002. Epub 2018 Aug 14.

Wanneer patiënten met het prikkelbare darmsyndroom, afgekort PDS-D na een darminfectie 8 weken lang het voedingsupplement Glutamine nemen dan nemen alle klachten inclusief de darmdoorlaatbaarheid sterk af in vergelijking met de patiënten die geen Glutamine kregen. Dat blijkt uit een placebo gecontroleerde gerandomiseerde studie. 

De resultaten na 8 weken wel of geen Glutamine :

Vijfenveertig proefpersonen in de Glutaminegroep en 52 in de placebogroep voltooiden de 8 weken durende studie.
  • Het primaire eindpunt trad op bij 43 patiënten (79,6%) in de Glutaminegroep en bij 3 patiënten (5,8%) in de placebogroep (een 14-voudig verschil).
  • Glutamine verminderde ook alle secundaire eindpunten:
  • IBS-SS-score na 8 weken (301 versus 181, p<0,0001),
  • dagelijkse stoelgangfrequentie (5,4 versus 2,9±1,0, p<0,0001),
  • Bristol Stool Scale (6,5 versus 3,9, p<0,0001) 
  • darmdoorlaatbaarheid (0,11 versus 0,05; p<0,0001).
  • 'darmdoorlaatbaarheid' (verhoogde lactulose/mannitol-ratio in de urine) werd genormaliseerd in de Glutaminegroep, maar niet in de controlegroep.
Bijwerkingen en het aantal gevallen van stopzetting van de studiemedicatie waren laag en vergelijkbaar in beide groepen. Er werden geen ernstige bijwerkingen waargenomen. 

Conclusie:

Bij patiënten met PDS-D met verhoogde darmdoorlaatbaarheid na een darminfectie verminderden orale Glutaminesupplementen alle belangrijke PDS-gerelateerde uitkomsten aanzienlijk en veilig. Grote gerandomiseerde klinische studies (RCT's) zijn nu nodig om deze bevindingen te valideren, de voordelen voor de kwaliteit van leven te beoordelen en de farmacologische mechanismen te onderzoeken.

Wat die laatste zin betreft heb ik geen fase III studies kunnen vinden maar misschien zijn die er wel maar zoek ik niet goed genoeg. Wel vind ik deze placebo gecontroleerde gerandomiseerde fase III studie voor het Chinese Tongxie Yaofang granules voor het prikkelbare darmsyndroom. Klik voor dat studierapport op de volgende link (abstract verderop in dit artikel):

Chinese herbal formula Tongxie Yaofang granules for diarrhoea-predominant irritable bowel syndrome: a randomised, double-blind, placebo-controlled, phase II trial

Het volledige studierapport is gratis in te zien of te downloaden, klik daarvoor op de titel van het abstract:

Abstract

Background: 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.

Methods: Eligible adults were randomised to glutamine (5 g/t.i.d.) or placebo for 8 weeks. The primary end point was a reduction of ≥50 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.

Results: 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<0.0001), daily bowel movement frequency (5.4 vs 2.9±1.0, p<0.0001), Bristol Stool Scale (6.5 vs 3.9, p<0.0001) and intestinal permeability (0.11 vs 0.05; p<0.0001). 'Intestinal hyperpermeability' (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.

Conclusions: 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.

Trial registration number: NCT01414244; 


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Despite showing clinically meaningful improvements in IBS-D symptoms and a reasonable safety profile after 8 weeks, no significant differences were observed between the TXYF and placebo groups.

Chinese herbal formula Tongxie Yaofang granules for diarrhoea-predominant irritable bowel syndrome: a randomised, double-blind, placebo-controlled, phase II trial

 1,2,3,4,  5,  5,  1,  1,  1,  1,  1,  5,  5,  5,  5,  5,  5,  5,  5,  5,  5,  5,  5,  5,  5,  6,  1,7,  1,✉
PMCID: PMC11772933  PMID: 39870499

Abstract

Objectives

To assess the therapeutic effects and safety of Tongxie Yaofang (TXYF) granules vs placebo as an alternative treatment for diarrhoea-predominant irritable bowel syndrome (IBS-D). We hypothesised that TXYF would improve clinical responses among patients with IBS-D.

Design

A randomised, double-blind, placebo-controlled, phase II, superiority trial.

Setting

Outpatients attending the Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, China.

Participants

96 eligible participants included men and women ranging from late adolescence to middle adulthood (18–65 years), diagnosed with IBS-D according to the Rome IV criteria. In addition, they were required to have an irritable bowel syndrome symptom severity score (IBS-SSS) of at least 75.

Interventions

TXYF granules (3.7 g) twice daily (taken orally before meals) or placebo for 8 weeks.

Primary and secondary outcomes

The primary outcome was the response rate measured by the change in IBS-SSS compared with baseline at week 8. Secondary outcomes included stool frequency; stool consistency at weeks 4, 8 and 20; and quality of life, anxiety and depression at week 8; and safety was monitored throughout the trial.

Results

The TXYF and placebo groups each comprised 48 participants. The response rate was not significantly different at week 8 between the two groups (the unadjusted treatment effect estimate (intention-to-treat analysis) was 1.12 (95% CI (0.89, 1.41)), p=0.348). Both groups had a high and similar rate of symptom reduction (79.2% (38/48) vs 70.8% (34/48)). There were no statistically significant differences between the two groups on secondary outcomes, although both groups showed substantial improvements. Adverse events in the TXYF and placebo groups were one (sinus arrhythmia) and two (elevated transaminases, weakly positive faecal occult blood), respectively. No serious adverse events occurred.

Conclusions

Despite showing clinically meaningful improvements in IBS-D symptoms and a reasonable safety profile after 8 weeks, no significant differences were observed between the TXYF and placebo groups. This suggests that the severity of IBS-D symptoms in both treatment arms might have decreased over time, regardless of the treatment, and highlights the need to investigate the relationship between IBS-D and patient psychology. Future large-scale, rigorously designed trials with longer treatment and follow-up periods are essential to evaluate the therapeutic effects and safety of TXYF, and to explore the psychological factors.

Trial registration number

ISRCTN12453166.

Strengths and limitations of this study.

  • A rigorous randomised, double-blind, placebo-controlled trial design was used, confirmed by a blinding test, to minimise biases and enhance the reliability of the study results.

  • This study used a longer 8 week treatment period and 12 week post-treatment follow-up compared with most previous studies of traditional Chinese medicine for IBS-D.

  • The results were analysed with the adjustment for baseline variables to exclude possible effects of confounding factors on the veracity of the findings.

  • This was a small sample, single-centre clinical trial, and the results may not be demographically and characteristically representative of the broader IBS-D population.

  • Outcome data were collected at only three time points, without additional measurement intervals, which limits our ability to precisely identify changes in efficacy or potential turning points over time.


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Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    online supplemental figure 1
    bmjopen-15-1-s001.doc (167KB, doc)
    DOI: 10.1136/bmjopen-2024-088410

    Data Availability Statement

    Data are available upon reasonable request.

    Articles from BMJ Open are provided here courtesy of BMJ Publishing Group

    glutamine, prikkelbare darmsyndroom, PDS-D, darminfectie, darmdoorlaatbaarheid, placebo


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