Ganz AS, Greeley B, Riggen J and Riggen A (2025) · Front. Med. 12:1572261
This open-label study evaluated the effects of a novel fiber supplement product, Relievance, on bowel movement regularity and symptoms of bloating and gas in 20 consecutive patients. The product is a commercially available combination of 8 natural fibers and the recommended dosage is approximately 6 grams per serving.
Participants presenting with chronic bothersome gastrointestinal symptoms of bloating, gas or bowel irregularity were recruited from an outpatient primary care practice. Participants consumed 6 g of the fiber blend (one heaping teaspoon), one to three times per day, over 6 weeks, and kept diaries on symptoms and number of bowel movements per week. Symptoms were assessed via a 6-point analog scale at baseline and at 6 weeks.
At baseline, participants averaged 1.7 bowel movements per week, which significantly increased to 3.2 per week by the study's conclusion. Symptom severity scores for bloating and gas also improved significantly, decreasing from 3.0 at baseline to 1.5 after 6 weeks. No significant adverse events were reported during the study, highlighting the product's safety profile.
This small, non-randomized prospective trial suggests that Relievance, a proprietary blend of eight different fibers, may effectively enhance bowel movement frequency and alleviate symptoms of bloating and gas. Further randomized controlled trials are warranted to confirm these findings and explore broader applications.
Dietary fiber is a diverse group of plant-derived carbohydrates that resist digestion in the human small intestine and undergo partial or complete fermentation in the colon. Fiber is broadly classified into two categories: soluble and insoluble, based on its solubility in water. Soluble fiber, found in foods such as oats, beans, and certain fruits, dissolves in water to form a gel-like substance and can modulate glycemic control and lipid metabolism. Insoluble fiber, prevalent in whole grains and vegetables, adds bulk to stool and facilitates bowel regularity.
Beyond these classifications, fermentable and non-fermentable fibers play a significant role in gut health, impacting microbial composition and metabolic byproducts such as short-chain fatty acids (SCFAs), which are vital for colonic health and systemic metabolic regulation.
The health benefits of dietary fiber extend beyond gastrointestinal function, influencing systemic outcomes such as cardiovascular health, glucose metabolism, and weight management. In the gut, fiber serves as a substrate for microbial fermentation, promoting a balanced microbiome and enhancing colonic motility. Soluble fibers, such as inulin and psyllium, have been shown to improve stool consistency and alleviate symptoms of constipation, while insoluble fibers primarily contribute to mechanical stimulation of peristalsis. Fiber consumption has also been associated with a reduced risk of colorectal cancer and inflammatory bowel diseases.
However, excessive fiber intake or an imbalance in fiber types can lead to adverse effects such as bloating, gas, and abdominal discomfort, highlighting the need for an optimized combination of fiber types to maximize benefits while minimizing side effects.
Emerging research suggests that combining various fiber types can yield synergistic health benefits by targeting different aspects of gut physiology. A combination of soluble and insoluble fibers, along with fermentable prebiotic fibers, can optimize bowel habits, support microbiota diversity, and reduce gastrointestinal symptoms.
The main objective of the present study was to assess the impact of a novel supplement containing a combination of eight different fiber types on gut symptoms, with a particular focus on bloating, gas, and bowel habit regulation. Utilizing a prospective, nonrandomized patient series, the study employed six-point analog questionnaires to evaluate patient-reported outcomes before and after supplement use.
The study product, Relievance, is a proprietary, commercially available over-the-counter fiber powder supplement composed of a blend of eight different fibers. The fibers in Relievance include a combination of soluble, partially soluble, and insoluble fibers, with varying fermentability and viscosities. This formulation is designed to provide a comprehensive approach to gut health by combining fibers with different physical and chemical properties, promoting bowel regularity, supporting microbial diversity, and potentially reducing gastrointestinal symptoms such as bloating and gas.
A prospective, nonrandomized, open label patient series with rolling admission was conducted to evaluate the effects of a novel fiber supplement, "Relievance," on gastrointestinal symptoms, specifically bloating, gas, and bowel regularity. The primary endpoints included changes in self-reported bloating and gas severity, and the number of bowel movements per week while taking the supplement compared to baseline. Secondary endpoints included the assessment of any adverse events reported by participants throughout the study period.
A total of 20 outpatients were recruited from a single outpatient primary care medical practice (LX Medical, Edina, MN). Any person with symptoms appropriate for fiber supplementation was eligible. Potential participants were screened based on patient perceived bothersome gas, bloating, or bothersome bowel irregularity. Modified Rome criteria for functional constipation or constipation-predominant IBS (IBS-C) were used to assess potential study participants but were not mandatory for entry into the study.
Participants were instructed to use the fiber product (Relievance) as currently labeled, with a dosage of 6 grams per day (one heaping teaspoon), initially taken once daily, increasing up to 3 heaping teaspoons a day (maximum dose 18 grams/day) on an as needed basis. The fiber product was mixed and stirred with any liquid of the participant's choice. Participants were allowed to continue all their typical care, lifestyle, medications, prebiotics or fibers they were currently using.
Participants were prospectively assessed for symptoms at baseline and at 6 weeks of product use. The primary endpoints — number of bowel movements and symptom severity of bloating and gas — were assessed by number of bowel movements in the last 7-day period at baseline and at 6 weeks, by patient recall/diary. The co-primary endpoint, reduction in bloating or gas, was assessed using analog scales, by 72-h recall at baseline and at 6 weeks.
Descriptive statistics were used to summarize participant characteristics. The primary endpoints were analyzed using the Student's paired t-test, with an alpha value of 0.05, and pre-test probability of 30% improvement in number of bowel movements per week or 30% improvement in bloating or gas symptom scores. The study employed a pre-post design wherein each patient served as their own control. A p-value <0.05 was considered statistically significant.
Specific inclusion criteria included adults aged 18–90 who met one of the following groups of criteria for at least 3 months, with symptom onset at least 6 months prior.
A total of 20 patients were consecutively enrolled in the study. Of these, 17 (85%) were Caucasian, 2 (10%) were Black, and 1 (5%) was of mixed race. The study population was 65% female and 35% male, with an age range of 21 to 80 years. Baseline body mass index (BMI) ranged from 19.9 to 34.3 kg/m².
Sixteen participants took either one heaping teaspoon (80%), and four took 2 heaping teaspoons (20%) of the fiber supplement daily. The supplement was well tolerated, with 19 of 20 participants (95%) reporting no adverse events. One participant (5%) developed hives within 1 week of starting the product; however, the relationship to the supplement was unclear. The hives resolved within 24 hours without medication, and this participant completed the study protocol without further issues.
| Patient # | Age | Ethnicity | BMI | Dose (tsps/day) | Initial Symptoms | Follow-up Symptoms | Adverse Events |
|---|---|---|---|---|---|---|---|
| 001 | 70 | Caucasian | 26.2 | One | 5 | 3 | None |
| 002 | 79 | Caucasian | 21.2 | One | 4 | 2 | None |
| 003 | 53 | Caucasian | 28 | One | 4 | 0 | None |
| 004 | 49 | Caucasian | 19.5 | Two | 3 | 0 | None |
| 005 | 55 | Caucasian | 21.7 | One | 2 | 1 | None |
| 006 | 54 | Caucasian | 22 | One | 1 | 1 | None |
| 007 | 53 | Mixed race | 19.9 | One | 4 | 3 | None |
| 008 | 21 | Black | 28 | One | 4 | 3 | None |
| 009 | 80 | Caucasian | 28.2 | Two | 2 | 0 | None |
| 010 | 65 | Caucasian | 29.8 | One | 3 | 2 | None |
| 011 | 70 | Black | Unknown | One | 2 | 1 | None |
| 012 | 76 | Caucasian | 33.6 | One | 3 | 4 | None |
| 013 | 21 | Caucasian | 25.0 | Two | 3 | 3 | None |
| 014 | 44 | Caucasian | Unknown | Two | 4 | 2 | None |
| 015 | 46 | Caucasian | 25.6 | One | 5 | 2 | None |
| 016 | 48 | Caucasian | 34.3 | One | 2 | 1 | Hives |
| 017 | 38 | Caucasian | 22.5 | One | 1 | 0 | None |
| 018 | 78 | Caucasian | 20.2 | One | 3 | 0 | None |
| 019 | 71 | Caucasian | 20.6 | One | 3 | 2 | None |
| 020 | 35 | Caucasian | 27 | One | 2 | 1 | None |
| Patient # | Age | Ethnicity | BMI | Dose (tsps/day) | BMs/week Baseline | BMs/week Post | Adverse Events |
|---|---|---|---|---|---|---|---|
| 001 | 70 | Caucasian | 26.2 | One | 0 | 2 | None |
| 002 | 79 | Caucasian | 21.2 | One | 2 | 4 | None |
| 003 | 53 | Caucasian | 28 | One | 0 | 4 | None |
| 004 | 49 | Caucasian | 19.5 | Two | 2 | 5 | None |
| 005 | 55 | Caucasian | 21.7 | One | 3 | 4 | None |
| 006 | 54 | Caucasian | 22 | One | 5 | 5 | None |
| 007 | 53 | Mixed race | 19.9 | One | 2 | 3 | None |
| 008 | 21 | Black | 28 | One | 3 | 4 | None |
| 009 | 80 | Caucasian | 28.2 | Two | 1 | 2 | None |
| 010 | 65 | Caucasian | 29.8 | One | 2 | 3 | None |
| 011 | 70 | Black | Unknown | One | 3 | 4 | None |
| 012 | 76 | Caucasian | 33.6 | One | 1 | 2 | None |
| 013 | 21 | Caucasian | 25.0 | Two | 3 | 3 | None |
| 014 | 44 | Caucasian | Unknown | Two | 2 | 4 | None |
| 015 | 46 | Caucasian | 25.6 | One | 1 | 4 | None |
| 016 | 48 | Caucasian | 34.3 | One | 2 | 3 | Hives |
| 017 | 38 | Caucasian | 22.5 | One | 0 | 1 | None |
| 018 | 78 | Caucasian | 20.2 | One | 0 | 3 | None |
| 019 | 71 | Caucasian | 20.6 | One | 2 | 3 | None |
| 020 | 35 | Caucasian | 27 | One | 0 | 1 | None |
Dietary fiber plays a crucial role in human health, supporting digestive function, metabolic regulation, and overall well-being. The inclusion of fiber in daily diets has been shown to promote gut health, improve bowel regularity, and reduce symptoms such as bloating and gas. Combining different types of fibers with varying solubility, fermentability, and viscosity can offer synergistic benefits, enhancing gastrointestinal comfort and promoting a balanced gut microbiota.
Research suggests that fiber combinations can support a more diverse gut microbiome compared to single fiber sources, as different fibers serve as substrates for distinct microbial populations. A diverse gut microbiome has been linked to improved digestive function, enhanced immune response, and reduced risk of chronic diseases such as obesity, diabetes, and inflammatory conditions.
The key findings in this small, nonrandomized prospective series are that use of Relievance, a proprietary blend of eight different fibers, was associated with a significant reduction in bloating and gas symptoms, with participants reporting an improvement of at least 30% based on six-point analog scale assessments. Additionally, bowel regularity improved by an average of more than one spontaneous bowel movement per week, indicating the potential efficacy of the supplement in enhancing gut motility and function. Importantly, Relievance was well tolerated, with no significant adverse events reported, and participants found the product easy to take as part of their daily routine.
These findings suggest that the diverse fiber composition in Relievance may not only help alleviate gastrointestinal symptoms but may also contribute to microbiome diversity, which could have significant systemic health benefits.
Despite these promising results, the nonrandomized design and relatively small sample size of this patient series present limitations that should be considered.
Overall, this study provides encouraging preliminary evidence that Relievance may be a beneficial, well-tolerated, and convenient intervention for individuals experiencing bloating, gas, and irregular bowel habits. The potential of combination fiber supplements to promote a more diverse gut microbiome may offer additional systemic health benefits beyond gastrointestinal symptom relief.
