DAVID S. GREENBAUM, M.D.; GARY E. STEIN, PHARM. D.
To the editor: The prevalence and generally unsatisfactory treatment of irritable bowel syndrome make it a legitimate and necessary target for research. In a recent article (1) on psyllium therapy in this disorder Longstreth and associates pointed out, as have others, that few treatments have been tested adequately (2, 3). Because of the high placebo response rate it is particularly important that clinical trials be well designed (4).
Unfortunately, this study, which purported to show that psyllium treatment is ineffective in irritable bowel syndrome, may be flawed. A true placebo must have no exogenous pharmacologic effects. In the reported study,
GREENBAUM DS, STEIN GE. Psyllium and the Irritable Bowel Syndrome. Ann Intern Med. ;95:660. doi: 10.7326/0003-4819-95-5-660_1
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Published: Ann Intern Med. 1981;95(5):660.
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