Randomized, paired studies were carried out on five healthy volunteers equipped with terminal ileostomies to investigate the effect of incorporating 15 g of the viscous polysaccharide guar gum in the normal diet on the volume, weight, composition and physical properties of ileostomy effluent. Subjects ate an identical diet during two 5 d study periods, which were separated by 2 d. Outputs of fat, protein, sodium, potassium, dry weight and water were all increased during guar gum administration, but outputs of carbohydrate, calcium and phosphorus were not significantly altered. Mouth-to-stoma transit was not significantly affected and, surprisingly, the viscosity of the ileostomy effluent was reduced by guar gum. These results show that it is not always possible to predict what will happen to small intestinal function when guar gum is added to the diet from experiments carried out when guar gum is administered alone or with glucose. While our findings show that guar gum will reduce fat absorption, the mechanisms involved are more sophisticated than hitherto envisaged.
