Guar gum

Guar gum  Download PDF

• J.K. Aronson MA, DPhil, MBChB, FRCP, HonFBPhS, HonFFPM

Meyler's Side Effects of Drugs, 634-634

General information

Guar gum is a low-viscosity water-soluble dietary fiber that has been used to treat diabetes because it slows the absorption of glucose from the gut. However, adverse reactions such as regurgitation, obstipation, abdominal cramps, diarrhea, and itching are common [  ]. Partially hydrolyzed guar gum has been added to enteral formulas and food products as a source of dietary fiber; it can reduce laxative use, diarrhea in septic patients receiving total enteral nutrition, and symptoms of irritable bowel syndrome [  ].

In a systematic review of 11 trials of the use of guar gum to treat obesity, the most common adverse events were abdominal pain, flatulence, diarrhea, and cramps; 11 patients (3%) dropped out owing to adverse events [  ].

Organs and systems

Gastrointestinal

Of 26 reports of suspected adverse reactions to a diet formulation containing guar gum (Cal-Ban 3000), there were 18 cases of esophageal obstruction and seven of small bowel obstruction [  ]. There were pre-existing esophageal or gastric disorders in 50% of those with esophageal obstruction, including peptic stricture, pyrosis, hiatus hernia, esophagitis, gastric stapling, Schatzki ring, and muscular dystrophy. Of 14 patients with esophageal obstruction who were treated successfully by endoscopy, although the tenacious gel-like material was often difficult to remove, one developed a fatal pulmonary embolism after surgical repair of an intraoperative esophageal tear.

Immunologic

Guar gum can cause occupational rhinitis [  ] and asthma [  ]. Of 162 employees at a carpet-manufacturing plant where guar gum was used to adhere dye to the fiber, 37 (23%) had a history suggestive of occupational asthma and 59 (36%) occupational rhinitis [  ]. Eight (5%) had immediate skin reactivity to guar gum and 11 (8.3%) had serum IgE antibodies to guar gum.

An employee of a pet food plant developed a severe cough, rhinitis, and conjunctivitis, and skin tests confirmed guar allergy. The symptoms resulted in obstructive sleep apnea which resolved after an absence from work and recurred after rechallenge with guar gum dust [  ].