How does dietary fiber affect stool frequency in constipated patients. What is the effect of fiber on stool consistency and laxative use. Does increased fiber intake reduce painful defecation.

The Significance of Dietary Fiber in Managing Constipation

Constipation is a widespread health issue affecting approximately 20% of the global population. This prevalent condition not only diminishes quality of life but also potentially increases the risk of colon cancer. While various treatment options exist, dietary fiber has emerged as a promising alternative to conventional methods like laxatives, which may have adverse effects with frequent use.

Dietary fiber, comprising both soluble and insoluble components, plays a crucial role in digestive health. Soluble fiber absorbs water, forming a gelatinous substance fermented by gut bacteria, while insoluble fiber provides bulk to the stool. The potential benefits of increased fiber intake for constipation relief have been widely recommended for both children and adults.

Methodology of the Meta-Analysis

To quantitatively assess the impact of dietary fiber on constipation, a comprehensive meta-analysis of randomized controlled trials (RCTs) was conducted. The study involved a thorough search of medical databases, including Ovid MEDLINE, Cochrane Library, and PubMed, using relevant keywords such as constipation, fiber, cellulose, plant extracts, cereals, bran, psyllium, and plantago.

The selection criteria for inclusion in the meta-analysis were:

• High-quality RCTs
• Reported data on stool frequency
• Information on stool consistency
• Treatment success rates
• Laxative use
• Gastrointestinal symptoms

Data extraction was independently performed by two researchers, ensuring the reliability of the collected information. The analysis utilized Review Manager version 5 software, employing weighted mean difference with 95% CI for quantitative data and odds ratio (OR) with 95% CI for dichotomous data.

Key Findings on Stool Frequency

The meta-analysis revealed a significant advantage of dietary fiber over placebo in improving stool frequency. The odds ratio (OR) was 1.19 with a 95% confidence interval (CI) of 0.58-1.80, indicating a statistically significant increase in the number of stools per week in the treatment group compared to the placebo group (P < 0.05).

Is dietary fiber effective in increasing stool frequency? The analysis of five RCTs consistently showed either a trend or a significant difference favoring the treatment group. This finding suggests that increasing dietary fiber intake can be an effective strategy for managing constipation by promoting more frequent bowel movements.

Impact on Stool Consistency and Treatment Success

While the effect on stool frequency was clear, the meta-analysis found no significant difference between dietary fiber and placebo groups in terms of stool consistency. Four studies evaluated this aspect, with one presenting outcomes in terms of percentage of hard stools, which differed from the others and was consequently excluded from the analysis.

How does dietary fiber affect treatment success rates? Two studies reported on treatment success, but significant heterogeneity was observed between these studies (P < 0.1, I2 > 50%). This heterogeneity makes it challenging to draw definitive conclusions about the overall impact of dietary fiber on treatment success.

Laxative Use and Painful Defecation

The meta-analysis also examined the effect of dietary fiber on laxative use and painful defecation. Three studies reported on laxative use, with one providing quantitative data. The pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use (OR = 1.07; 95% CI 0.51-2.25), with no heterogeneity observed (P = 0.84, I2 = 0).

Does increased fiber intake reduce the need for laxatives? Based on the available data, there is no clear evidence to suggest that dietary fiber significantly reduces laxative use in constipated patients. However, more research may be needed to confirm this finding.

Regarding painful defecation, three studies evaluated this outcome. One study presented both quantitative and dichotomous data, while the other two reported these data types separately. The analysis used dichotomous data and found no significant improvement in painful defecation with increased fiber intake.

Implications for Constipation Management

The results of this meta-analysis have important implications for the management of constipation. While dietary fiber shows clear benefits in increasing stool frequency, its effects on other aspects of constipation, such as stool consistency and treatment success, are less pronounced.

How can healthcare providers use this information to guide patient care? These findings suggest that recommending increased dietary fiber intake can be a valuable strategy for improving stool frequency in constipated patients. However, it’s important to note that fiber may not significantly impact other symptoms of constipation, such as stool consistency or the need for laxatives.

Limitations and Future Research Directions

Despite the valuable insights provided by this meta-analysis, several limitations should be considered:

1. The relatively small number of studies included in the final analysis
2. Heterogeneity in some outcome measures across studies
3. Variability in the types and amounts of dietary fiber used in different studies

What areas require further investigation to better understand the role of dietary fiber in constipation management? Future research should focus on:

• Larger, well-designed RCTs with standardized outcome measures
• Studies comparing different types and doses of dietary fiber
• Long-term follow-up to assess the sustained effects of increased fiber intake
• Investigation of potential mechanisms underlying the effects of dietary fiber on constipation

Practical Recommendations for Increasing Dietary Fiber Intake

Given the positive effect of dietary fiber on stool frequency, it’s important to consider practical ways to increase fiber intake in the diet. Here are some recommendations:

• Incorporate a variety of high-fiber foods, including fruits, vegetables, whole grains, and legumes
• Gradually increase fiber intake to minimize potential gastrointestinal discomfort
• Ensure adequate hydration to support the beneficial effects of dietary fiber
• Consider fiber supplements under the guidance of a healthcare provider if dietary changes alone are insufficient

How much fiber should individuals consume daily? The recommended daily intake of dietary fiber varies by age and gender, but generally ranges from 25 to 38 grams per day for adults. It’s important to consult with a healthcare provider or registered dietitian for personalized recommendations.

Potential Side Effects and Precautions

While increasing dietary fiber intake is generally safe and beneficial, some individuals may experience side effects, especially if the increase is sudden or excessive. These may include:

• Bloating
• Gas
• Abdominal discomfort

To minimize these effects, it’s advisable to increase fiber intake gradually over several weeks and ensure adequate fluid intake. Individuals with certain gastrointestinal conditions should consult their healthcare provider before significantly increasing their fiber intake.

The Role of Dietary Fiber in Overall Digestive Health

Beyond its effects on constipation, dietary fiber plays a crucial role in maintaining overall digestive health. Some additional benefits of a high-fiber diet include:

• Promoting a healthy gut microbiome
• Reducing the risk of diverticular disease
• Supporting weight management
• Helping to regulate blood sugar levels
• Potentially lowering cholesterol levels

How does dietary fiber contribute to these health benefits? Fiber acts as a prebiotic, providing nourishment for beneficial gut bacteria. It also helps to regulate the speed of digestion, which can impact nutrient absorption and blood sugar control. Additionally, the bulking effect of fiber can promote feelings of fullness, aiding in weight management.

Fiber-Rich Foods to Include in Your Diet

To increase dietary fiber intake, consider incorporating the following foods into your daily meals:

1. Whole grains (e.g., oats, quinoa, brown rice)
2. Legumes (e.g., lentils, chickpeas, beans)
3. Fruits (e.g., berries, apples, pears)
4. Vegetables (e.g., broccoli, Brussels sprouts, carrots)
5. Nuts and seeds (e.g., almonds, chia seeds, flaxseeds)

What are some easy ways to boost fiber intake throughout the day? Try adding berries to your breakfast, choosing whole grain bread for sandwiches, snacking on raw vegetables with hummus, and including a serving of legumes in your dinner meals.

Comparing Dietary Fiber to Other Constipation Treatments

While this meta-analysis focuses on the effects of dietary fiber, it’s important to consider how it compares to other common treatments for constipation. Some alternative approaches include:

• Osmotic laxatives
• Stimulant laxatives
• Stool softeners
• Probiotics
• Lifestyle modifications (e.g., increased physical activity, proper hydration)

How does dietary fiber compare to these other treatments in terms of efficacy and safety? Dietary fiber offers several advantages:

1. Natural approach with fewer side effects compared to some medications
2. Can be easily incorporated into daily diet
3. Provides additional health benefits beyond constipation relief
4. Suitable for long-term use without developing dependence

However, in cases of severe or chronic constipation, a combination of treatments may be necessary, and individuals should work closely with their healthcare providers to develop an effective management plan.

The Importance of Individualized Approaches

It’s crucial to recognize that the effectiveness of dietary fiber in managing constipation may vary among individuals. Factors that can influence response to increased fiber intake include:

• Overall diet composition
• Hydration status
• Physical activity levels
• Underlying medical conditions
• Medications

How can healthcare providers tailor fiber recommendations to individual patients? A personalized approach that considers these factors, as well as patient preferences and lifestyle, is likely to yield the best results. This may involve keeping a food diary, gradually adjusting fiber intake, and regular follow-ups to assess effectiveness and make necessary modifications.

Future Perspectives in Constipation Management

As research in the field of gastroenterology and nutrition continues to advance, new insights into constipation management are likely to emerge. Some areas of ongoing research and potential future developments include:

• Targeted prebiotics and synbiotics for gut health
• Personalized nutrition based on individual gut microbiome profiles
• Novel fiber formulations with enhanced therapeutic properties
• Integration of digital health technologies for monitoring and managing constipation

How might these advancements shape the future of constipation treatment? As our understanding of the complex interactions between diet, gut microbiome, and gastrointestinal function improves, we may see more precise and effective strategies for managing constipation. This could lead to improved quality of life for millions of individuals affected by this common condition.

In conclusion, while dietary fiber shows promise in increasing stool frequency for constipated patients, its effects on other aspects of constipation appear limited. As research continues, a comprehensive approach that combines dietary modifications, lifestyle changes, and medical interventions when necessary remains the cornerstone of effective constipation management.

Effect of dietary fiber on constipation: A meta analysis

World J Gastroenterol. 2012 Dec 28; 18(48): 7378–7383.

Published online 2012 Dec 28. doi: 10.3748/wjg.v18.i48.7378

Author information Article notes Copyright and License information Disclaimer

AIM: To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials (RCTs).

METHODS: We searched Ovid MEDLINE (from 1946 to October 2011), Cochrane Library (2011), PubMed for articles on dietary fiber intake and constipation using the terms: constipation, fiber, cellulose, plant extracts, cereals, bran, psyllium, or plantago. References of important articles were searched manually for relevant studies. Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency, stool consistency, treatment success, laxative use and gastrointestinal symptoms. The data were extracted independently by two researchers (Yang J and Wang HP) according to the described selection criteria. Review manager version 5 software was used for analysis and test. Weighted mean difference with 95%CI was used for quantitative data, odds ratio (OR) with 95%CI was used for dichotomous data. Both I² statistic with a cut-off of ≥ 50% and the χ² test with a P value < 0.10 were used to define a significant degree of heterogeneity.

RESULTS: We searched 1322 potential relevant articles, 19 of which were retrieved for further assessment, 14 studies were excluded for various reasons, five studies were included in the analysis. Dietary fiber showed significant advantage over placebo in stool frequency (OR = 1.19; 95%CI: 0.58-1.80, P < 0.05). There was no significant difference in stool consistency, treatment success, laxative use and painful defecation between the two groups. Stool frequency were reported by five RCTs, all results showed either a trend or a significant difference in favor of the treatment group, number of stools per week increased in treatment group than in placebo group (OR = 1. 19; 95%CI: 0.58-1.80, P < 0.05), with no significant heterogeneity among studies (I²= 0, P = 0.77). Four studies evaluated stool consistency, one of them presented outcome in terms of percentage of hard stool, which was different from others, so we included the other three studies for analysis. Two studies reported treatment success. There was significant heterogeneity between the studies (P < 0.1, I² > 50%). Three studies reported laxative use, quantitative data was shown in one study, and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use (OR = 1.07; 95%CI 0.51-2.25), and no heterogeneity was found (P = 0.84, I²= 0). Three studies evaluated painful defecation: one study presented both quantitative and dichotomous data, the other two studies reported quantitative and dichotomous data separately. We used dichotomous data for analysis.

CONCLUSION: Dietary fiber intake can obviously increase stool frequency in patients with constipation. It does not obviously improve stool consistency, treatment success, laxative use and painful defecation.

Keywords: Dietary fiber, Constipation, Meta-analysis, Stool frequency, Stool consistency

Constipation is a health problem that influences almost 20% of the world’s population[1]. It is a bothersome disorder which negatively affect the quality of life and increase the risk of colon cancer[2]. There are a wide-range of treatment methods. Life-style modification, such as increased fluid intake or exercise, are usually recommended as first-line treatment, but data on the effectiveness of these measures are limited[3]. Laxatives are most commonly used for treatment of constipation, but frequent use of these drugs may lead to some adverse effects[4,5], alternative treatment measure is, therefore, needed. Soluble fiber absorbs water to become a gelatinous, viscous substance and is fermented by bacteria in the digestive tract. Insoluble fiber has a bulking action[6]. Dietary fiber is the product of healthful compounds and has demonstrated some beneficial effect. Increase of dietary fiber intake has been recommended to treat constipation in children and adults[7-9]. In a large-population case-control study, Rome found that dietary fiber intake was independently negatively correlated with chronic constipation, despite the age range and the age at onset of constipation[10]. Although there have been several randomized controlled trials (RCTs) studying the relationship between dietary fiber and constipation, no definitive quantitative summary is available, therefore we conducted a meta-analysis of RCTs, and report it below.

Data selection

We searched Ovid MEDLINE (from 1946 to October 2011), Cochrane Library (2011) and PubMed to identify RCTs studying dietary fiber and constipation. We used the following terms: constipation as medical subject headings and free text terms, which were combined with fiber, cellulose, plant extracts, cereals, bran, psyllium or plantago. References of important articles were searched manually for relevant studies.

Study selection

Studies were included if they met the following criteria: (1) studies investigating the association between the intake of dietary fiber and constipation; (2) RCTs with a trial quality greater than or equal to 3 points judged by Jadad score; (3) constipation was defined by symptoms according to the Roma criteria or clinical diagnosis; (4) studies reporting at least one of the following data: stool frequency, stool consistency, treatment success, laxative use, gastrointestinal symptom; and (5) dietary fiber was used as the only active intervention in treatment group.

Data extraction

The data were extracted independently by two researchers (Yang J and Wang HP) according to the described selection criteria. Disagreement was resolved by discussion with the third person. The following data were extracted: the first author’s name, year of publication, study design, interventional method, study period, sample size, outcomes, method used to generate the randomization, level of blinding, withdrawn or drop-outs explanations.

Statistical analysis

Review manager version 5 software was used for all meta-analyses and tests for heterogeneity. Weighted mean difference with 95%CI was used for quantitative data, odds ratio with 95%CI was used for dichotomous data. Both I² statistic with a cut-off of ≥ 50% and the χ² test with a P value < 0.10 were used to define a significant degree of heterogeneity. Random-effects model was applied. A two-tailed P < 0.05 was considered statistically significant.

We searched 1322 potential relevant articles, 19 of which were retrieved for further assessment, and 14 studies were excluded for the reasons as shown in Figure . As a result, five studies were included, and the characteristics of the included studies are listed in Table .

Table 1

Basic characteristics of included studies

Study	Trial design	No. of patients	Interventional method	Duration (wk)	Randomized allocation/double-blind/description of withdrawn and dropouts	Jadad score
Badiali et al[11]	Double-blind crossover	24 (adults)	Bran 20 g (fiber 12.5 g) vs placebo	4	Y/Y/Y	4
Loening-Baucke et al[12]	Double-blind crossover	31 (children)	Glucomannan 100 mg/kg vs placebo	4	Y/Y/Y	5
Castillejo et al[13]	Double-blind	48 (children)	Fiber supplement 5. 2 g (53.2% fiber) 2 or 4 sachets vs placebo	4	Y/Y/Y	5
Chmielewska et al[14]	Double-blind	72 (children)	Glucomannan 2.52 g vs placebo	4	Y/Y/Y	5
Staiano et al[15]	Double-blind	20 (children)	Glucomannan 200 mg/kg vs placebo	12	Y/Y/Y	4

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Stool frequency was reported by five RCTs[11-15]. Results showed either a trend or a significant difference in favor of the treatment group, and an increased number of stools per week in treatment group compared with the placebo group [odds ratio (OR) = 1. 19; 95%CI: 0.58-1.80, P < 0.05], with no significant heterogeneity among the studies (I² = 0, P = 0.77). Of note, stool frequency was expressed as median (interquartile range) in Chmielewska’s study [14], and we used the formula to transform it into mean ± SD (Figure )[16].

Open in a separate window

Pooled estimate of odds ratio and 95%CI. A: Stool frequency; B: Stool consistency; C: Treatment success; D: Laxative use; E: Painful defecation. IV: Iverse variance; M-H: Mantel-Haenszel.

Four studies evaluated stool consistency[12-15], one of them presented outcome in terms of percentage of hard stool[13], which was different from others, so we included the other three studies for analysis. Results showed no statistical difference between two groups (OR = 0.43; 95%CI: -0.24-1.11, P > 0.05), however substantial heterogeneity existed (P < 0.1, I² > 75%) (Figure ).

Two studies reported treatment success[12,14]. The pooled analysis (Figure ) for overall results found significant difference between groups (OR = 2.21; 95%CI: 0.35-12.69, P > 0.05). There was significant heterogeneity between studies (P < 0.1, I² > 50%).

Three studies reported laxative use[12,14,15], quantitative data was shown in one study[15], and the pooled analysis (Figure ) of the other two studies showed no significant difference between treatment and placebo groups in laxative use (OR = 1.07; 95%CI: 0.51-2.25, P = 0.85), and no heterogeneity was present (P = 0.84, I² = 0%).

Three studies evaluated painful defecation[11,14,15]: one study presented both quantitative and dichotomous data[14], the other two studies separately reported quantitative and dichotomous data[11,15]. Evaluation method for quantitative data was different, one used actual frequency, the other two used frequency of occurrence (often/occasional/none). We used dichotomous data for analysis. The pooled estimate (Figure ) showed a nonsignificant trend in favor of treatment group (OR = 0.54; 95%CI: 0.15-1.91, P = 0.34). No statistically significant heterogeneity was present, but I² was moderate (P > 0.1, I² = 43%).

This meta-analysis shows that the number of stools was increased significantly in dietary fiber group. Results demonstrated either a trend or a significant difference in favor of dietary fiber group. As for stool consistency, the overall results showed a trend in favor of fiber group, but no statistical difference was found. The substantial heterogeneity may influence the results, and the heterogeneity may be caused by different rating scale, ranging from 0 to 4, from 0 to 5 and from 0 to 7 in three included studies, respectively. Although the rating sequence is unanimous, with a higher score indicating looser stools, different scale range may still influence the final results. Stool consistency was present as hard stool percentage in another included study[13], 41. 7% and 75% of the patients who received dietary fiber or placebo, respectively, reported hard stools, the percentage being obviously lower in the dietary fiber group.

Two high-quality RCTs compared dietary fiber with lactulose for treatment of constipation[17,18], and found that dietary fiber and lactulose achieved comparable results in the treatment of childhood constipation. Dietary fiber is as effective as lactulose in improving stool frequency, stool consistency and treatment success, however, no difference was observed in treatment success between dietary fiber and placebo group in our meta-analysis. The possible reason was discussed. Constipation condition was more severe in the patients in Chmielewska’s study, who had a lower baseline stool frequency per week and a higher percentage of hard stool than the studies mentioned above[17,18] and the other study[12] used for analysis. It suggests that dietary fiber may not be so effective in severe constipation and can only be used in mild to moderate constipation, or perhaps the dosage of glucomannan (2. 52 g/d) used in Chmielewska’s study is not high enough to exert effect. Nurko et al[19] suggested that behavior modification, such as parental positive reinforcement and good patient-doctor relationship, may have impact on the treatment outcome. So the effect of dietary fiber on different grades of constipation should be explored in further studies and it is also important to balance the behavior factors in comparison.

Dichotomous data was used to analyze the laxative use in our study, which can only reflect how many patients used the laxatives, but not indicate how often it was used. Quantitative data about laxative use can better reflect the degree of dependence. If the time when laxative was used is described, the outcome will be more useful for overall analysis.

Gastrointestinal symptoms were reported by several studies. Because data was presented by different methods, only painful defecation was analyzed, and results showed that there was no significant difference between dietary fiber and placebo groups.

We used rigid research methods and described search strategy, eligibility criteria and data extraction method in detail. We included high-quality studies (Jadad score ≥ 3) into the analysis. Because of the strict selection criteria, only five small sample-sized studies were included. Definite heterogeneity existed in the analysis. Neurologically impaired children were included, although no difference was present between dietary fiber and placebo groups during baseline period, disease itself can interfere with the outcome. Some of the studies are limited to pediatric patients, stool withholding and stool toileting refusal often occurred[20], which is uncommon among constipated adults, although no heterogeneity was found in the analysis of stool frequency, potential limitation still existed. As scarce data of gastrointestinal syndromes was reported, and different evaluation and presentation methods were used, less data can be used for the analysis.

There were meta-analyses examining the efficacy of fiber in constipation previously, in which data of fiber and laxative were pooled for analysis[21,22]. Recently, a systematic review of the efficacy of fiber in the management of chronic idiophic constipation was published[23], six RCTs were included, four RCTs compared the effect of soluble fiber with placebo[24-27], and one study[27] used the combined intervention with celandine, aloevera and psyllium. Celandin and aloevera contain several alkaloids with known aperient effect, which may influence the outcome of the patients. Of the two trials examining the effect of insoluble fiber[11,28], one trial[28] recruited patients with self-reported constipation, subjective error may be more obvious when the outcome was assessed by non-medical staff.

In summary, our meta-analysis demonstrated that dietary fiber can obviously increase stool frequency in patients with constipation. The result also showed that dietary fiber did not obviously improve stool consistency, treatment success, laxative use and painful defecation. However, there were some possible influential factors such as small sample-sized studies, severity of constipation, assessment method for outcomes, etc. So further large trials examining the effect of dietary fiber in the treatment of constipation are needed, the possible influential factors should be taken into consideration, and more gastrointestinal symptoms and adverse events should be reported before dietary fiber was formally recommended.

Background

Constipation is one of the widespread health problems. There is a wide-range of treatment methods. Life-style modification is usually recommended as first-line treatment, but data on the effectiveness of these measures are limited. Laxatives are most commonly used for treatment of constipation, but frequent use of these drugs may lead to some adverse effects, and alternative treatment measure is therefore needed. Increase of dietary fiber intake has been recommended to treat constipation of children and adults. There have been several randomized controlled trials (RCTs) studying the relationship between dietary fiber and constipation, however no definitive quantitative summary is available.

Research frontiers

Some studies reported that dietary fiber can increase stool frequency, improve stool consistency and have no obviously adverse effects. Two studies concluded that dietary fiber is as effective as lactulose treatment and seems to have less side effects. However, in another study, dietary fiber was not found more effective than placebo in therapeutic success and it might increase the frequency of abdominal pain.

Innovations and breakthroughs

This meta-analysis demonstrated that dietary fiber can obviously increase stool frequency in patients with constipation. The result also showed that dietary fiber did not obviously improve stool consistency, treatment success, laxative use and painful defecation, however, there were some possible influential factors such as small sample-sized studies, severity of constipation, and assessment method for outcomes. Further large trials examining the effect of dietary fiber in the treatment of constipation are needed, the possible influential factors should be taken into consideration and more gastrointestinal symptoms and adverse events should be reported before dietary fiber was formally recommended.

Applications

The study results suggest that dietary fiber intake is a potential therapeutic method that could be used in the treatment of constipation.

Terminology

Constipation: Present with any two of the six symptoms of less than 3 defecations per week, straining, lumpy or hard stools, sensation of incomplete evacuation, sensation of anorectal obstruction or blockage, digital maneuvers; Dietary fiber: Dietary fiber is a broad category of non-digestible food ingredients that includes non-starch polysaccharides, oligosaccharides, lignin, and analogous polysaccharides with an associated healthful benefit.

Peer review

The effectiveness of dietary fiber on constipation is inconsistent. So far no definitive quantitative summary is available. This is a well performed meta-analysis, in which the authors analyzed the effect of dietary fiber in constipation. The results are interesting and suggest that dietary fiber intake is a potential therapeutic method that could be used in preventing and treating constipation. This analysis provides valuable information for further trials and clinical application.

Peer reviewer: Dr. Giuseppe Chiarioni, Gastroenterological Rehabilitation Division of the University of Verona, Valeggio sul Mincio Hospital, Azienda Ospedale di Valeggio s/M, 37067 Valeggio s/M, Italy

S- Editor Gou SX L- Editor A E- Editor Li JY

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Does Fiber Relieve or Cause Constipation? A Critical Look

Eating fiber-rich foods can help optimize digestive health, but too much fiber may worsen constipation if insufficient fiber isn’t the cause.

Constipation is a common problem that affects up to 20% of people every year (1, 2).

It’s a difficult condition to define, as bathroom habits vary considerably from person to person.

However, if you have less than three bowel movements a week and your stools are hard, dry and difficult to pass, you’re likely constipated.

One of the most common pieces of advice for people who are constipated is to eat more fiber.

But does this advice actually work? Let’s have a look.

Fiber Is Generally Good for Digestion

Dietary fiber is the name given to the non-digestible carbohydrates in plants. It can be found in all plant foods, including fruits, vegetables, grains, nuts and seeds.

It’s usually categorized into two groups, based on solubility:

• Insoluble fiber: Found in wheat bran, vegetables and whole grains.
• Soluble fiber: Found in oat bran, nuts, seeds, beans, lentils and peas, as well as some fruits and vegetables.

That said, most fiber-rich foods contain a mixture of insoluble and soluble fiber in varying proportions.

Even though your body can’t digest fiber, eating enough of it is thought to be very important for your gut health. This is partly because dietary fiber increases the size of your stools and makes them softer.

Larger, softer stools help keep you regular, as they move more quickly through your bowels and are easier to pass (3).

These two types of fiber help with this in slightly different ways.

Insoluble fiber bulks up your stool and acts like a brush, sweeping through your bowels to get everything out and keep things moving.

The soluble variety absorbs water and forms a gel-like substance. This helps your stool pass smoothly through your bowels and improves its form and consistency.

The fermentation of one type of soluble fiber, known as prebiotics, in the large intestine can also help maintain a healthy gut by increasing its number of good bacteria (4).

This could also improve your health by decreasing your risk of type 2 diabetes, heart disease and obesity (5).

Bottom Line:

Eating enough fiber can help keep you regular. It can also improve the balance of good bacteria in your gut. This may reduce your risk of various diseases, such as heart disease, obesity and diabetes.

It Can Relieve Constipation for Many People

If you’re constipated and have a low fiber intake, eating more of it could help.

Studies have shown that increasing the amount of fiber you eat could increase the number of stools that you pass (6).

In fact, a recent review showed that 77% of people with chronic constipation found some relief by increasing their fiber intake (7).

Moreover, two studies have found that increasing dietary fiber intake could be as effective as the laxative lactulose for relieving constipation in children (8, 9).

This means that for many people with constipation, simply eating more fiber could be enough to fix the problem (10, 11).

It is generally recommended that men eat 38 grams of fiber per day, and that women eat 25 grams (12).

Unfortunately, it’s estimated that most people eat less than half of this amount, only reaching between 12–18 grams per day (3, 13, 14).

Bottom Line:

Most people don’t eat enough dietary fiber. Those who lack fiber in their diet may experience relief by increasing their intake.

In Some Cases, Eating More Fiber Makes Constipation Worse

In theory, fiber should help prevent and treat constipation.

However, the evidence shows that this advice does not work for everyone.

While some studies show that adding fiber to your diet may improve your symptoms, other studies show that reducing your intake is best (15).

Also, a recent review found that although fiber was effective at increasing the number of bowel movements, it didn’t help with other symptoms of constipation like stool consistency, pain, bloating and gas (6).

To find out if increasing your fiber intake will help your constipation, try to determine its cause. You can become constipated for a number of reasons, including:

• Lifestyle factors: Low dietary fiber intake, inactivity and low fluid intake.
• Medications or supplements: Examples include opioid painkillers, antidepressants, antipsychotics and some antacids.
• Disease: Examples include diabetes, irritable bowel syndrome, inflammatory bowel disease and neurological conditions like Parkinson’s.
• Unknown: The cause of some people’s chronic constipation is unknown. This is known as chronic idiopathic constipation.

If you already eat plenty of fiber and your constipation is caused by something else, then adding more fiber may not help and could even make the problem worse (15).

Interestingly, studies have shown that some people with constipation eat similar amounts of fiber as those who don’t have the condition (16, 17).

One 6-month study in 63 people found that for people with chronic idiopathic constipation, a low-fiber or even a no-fiber diet drastically improved their symptoms. Removing the fiber basically cured them of the constipation (18).

This is also true for people who have irritable bowel syndrome (IBS), as many high-fiber foods are also high in FODMAPS, which worsen IBS symptoms (19, 20).

Nevertheless, given fiber’s potential health benefits, you shouldn’t adopt a low-fiber diet over the long term without consulting your doctor or dietitian.

Furthermore, there’s evidence that non-fermentable, soluble fiber supplements may benefit these individuals, even though they don’t tolerate other types of fiber well.

Bottom Line:

For people who eat enough fiber but are still constipated, eating more of it could make their problems worse. In some cases, reducing dietary fiber could help relieve constipation.

The Best Types of Fiber to Get Rid of Constipation

Fiber supplements can help treat constipation, including for those who have chronic constipation or IBS (21).

However, if you have chronic constipation or are experiencing symptoms like pain, wind, bloating and gas, it may be best to go for a non-fermentable, soluble fiber supplement (22, 23, 24).

This is because fermentable fiber is used as food by the bacteria in your gut, resulting in the production of gases in your large intestine.

This could cause an increase in gas production in your gut, which might make your symptoms worse.

Examples of soluble fiber supplements include:

• Psyllium: Psyllium husk and Metamucil
• Methyl cellulose: Citrucel
• Glucomannan: Glucomannan capsules or PGX
• Inulin: Benefibre (Canada), Fiber Choice or Fibersure
• Partially hydrolyzed guar gum: Hi-Maize
• Wheat dextrin: Benefiber (US)

Psyllium is often considered to be the best choice.

Despite being classified as fermentable, studies have shown that psyllium can normalize stools and is well tolerated, even by people with IBS (25, 26, 27).

Bottom Line:

If you don’t get enough fiber, gradually increasing the amount of high-fiber foods in your diet could help. People with chronic constipation may benefit from a non-fermentable, soluble fiber supplement.

Best Foods to Relieve Constipation

If your fiber intake is generally low, try including more high-fiber foods like fruits, vegetables and whole grains in your diet.

This will increase both your soluble and insoluble fiber intake and could help relieve your problem.

It’s best to do this gradually, as dramatically increasing your intake in a short period could cause unwanted side effects like pain, gas and bloating.

Foods high in insoluble fiber include:

• Whole grains
• Fruits and vegetables with skins
• Nuts and seeds

Foods high in soluble fiber include:

• Oats
• Flax seeds
• Barley
• Rye
• Beans and pulses
• Root vegetables

Some high-fiber foods have been shown to be particularly effective for constipation. For example, flax seeds could help if your constipation is caused by IBS (28, 29).

If you want to try flax seeds, start by taking 1 teaspoon per day and gradually increase the dose up to a maximum of 2 tablespoons throughout the day.

To make them more palatable, you can put them in a drink or sprinkle them on your yogurt, salad, cereal or soup.

Prunes can also help relieve constipation. They’re high in fiber and also contain the sugar alcohol sorbitol, which is a natural laxative (30, 31).

Some studies have shown that prunes are more effective than fiber supplements at relieving constipation. The effective dosage is thought to be around 50 grams (or 7 medium-sized prunes) twice a day (32, 33).

However, if you have IBS, you should probably avoid prunes since sorbitol is a known FODMAP and can exacerbate your symptoms.

Bottom Line:

Insoluble and soluble fiber are found naturally in many foods. Prunes may also be helpful, as long as you don’t have IBS.

Take Home Message

Eating plenty of fiber-rich foods is a good idea to optimize digestive health.

If you become constipated and don’t have much fiber in your diet, then you may benefit from eating more of it.

However, if you already get enough fiber or your constipation has another cause, increasing your fiber intake from foods may make things worse.

You may also like these related articles:

• 13 Home Remedies to Relieve Constipation Naturally
• 22 High-Fiber Foods You Should Eat
• 16 Easy Ways to Eat More Fiber
• Good Fiber, Bad Fiber – How The Different Types Affect You
• FODMAP 101: A Detailed Beginner’s Guide

What foods contain a lot of fiber useful for constipation

Table of contents

• What can frequent constipation indicate?
• What is fiber and how does it work for constipation?
• What foods contain fiber?
• What else can be used for constipation problems?
• Statement

Disclaimer

Please note that all information posted on the site
Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

Which foods contain a lot of fiber useful for constipation

The inability to free the intestines from feces for a long time is called constipation. Fiber is often used to combat this condition. What foods are rich in it?

What can frequent constipation indicate?

Constipation is not an independent disease. This condition is usually accompanied by hardening of the feces, and occurs due to the fact that the patient’s body is not working properly. Constipation can be the result of the following violations:

• The person eats incorrectly, not balanced. Most likely, he consumes a lot of heavy food (fatty, fried, smoked meats).
• Lack of fresh vegetables and fruits in the diet, eating semi-finished and canned foods.
• Insufficient fluid intake, violation of the drinking regimen.
• Frequent stress, disorders of the nervous system, emotional breakdowns.
• Late pregnancy, when the fetus begins to put pressure on the internal organs.
• Diseases of the endocrine system (improper functioning of the thyroid gland, insufficient secretion of enzymes).
• Uncontrolled, prolonged or incorrect use of drugs.

What is fiber and how does it work for constipation?

Fiber is a natural dietary fiber. They are part of fresh vegetables and fruits, cereals and bran. If you regularly eat foods with fiber, then after a while the intestines will clear and begin to work normally.

The advantage of dietary fiber is that they are not processed and do not dissolve under the influence of gastric juice. The liquid acts on them so that they increase in volume and produce the necessary mucus. This contributes to the easy release of feces from the body. The person does not experience pain and discomfort.

What foods contain fiber?

With constipation, the patient should pay attention to the following foods rich in dietary fiber:

1. Prunes. In order not to cause diarrhea, you should not overdo it with this dried fruit. It is enough to eat 4-5 pieces of prunes at breakfast to improve the process of digestion and defecation. The intestine, thanks to him, works more actively, produces the necessary enzymes. Prunes strengthen it and help the development of beneficial microflora.
2. Prickly bush berries (raspberries, blackberries). They have a lot of natural fibers and moisture, so they have a targeted effect on constipation.
3. Whole grain products. If they are consumed regularly, the body will have enough fiber to cope with constipation. You can also use flour products, but made from unprocessed flour. But refined and purified foods do not carry such benefits, so it is better not to add them to your diet (or significantly reduce their use).
4. Legumes and nuts. A lot of fiber is found in peas, beans, sunflower seeds, sesame seeds and flax seeds. But you shouldn’t use them too much. These foods can cause increased gas formation in the intestines, which is accompanied by pain.

What else can I use for constipation?

To enhance the effect of products with fiber, you can use the following means:

1. Fresh fruits and vegetables, herbs. They activate intestinal motility, make it work more actively.
2. Natural vegetable oils and fish oils. Envelop the intestines.
3. Cereal cereals. Positive effect on intestinal muscles.
4. Kefir. Allows you to easily get rid of feces in the morning.

Conclusion

Thus, the problem of constipation can threaten with serious consequences, intoxication of the body, and poor health. To solve it, you need to eat foods with fiber.

Disclaimer

Please note that all information posted on the site
Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

Expert: Ekaterina Vladimirova Expert in maternity and child nutrition

Reviewer: Ekaterina Vorobieva Adept of a healthy and active lifestyle

What happens to the intestines if you eat too much fiber

• Health
• Lifestyle

Fiber is essential for satiety and good metabolism. And it also helps those who lose weight to lose weight, so some lean on dried apricots, hercules and legumes, without thinking that an excess can do much harm.

May 2, 2022

Source:

iStockphoto

Fiber should be included in your daily diet: it is digested more slowly, thereby providing a feeling of satiety for a long time, reduces the risk of cardiovascular diseases by almost 25 percent. Also, studies of past years have proven that dietary fiber can protect against colon cancer, type 2 diabetes.

Back in pre-Soviet times, experts from the Division of Epidemiological Nutrition at the National Cancer Institute in Maryland found that mortality from infectious and respiratory diseases with sufficient fiber intake in men is reduced to 56 percent, in women – to 59percent.

Everyone who loses weight knows for sure that fiber is essential in the diet. After all, dietary fiber is digested more slowly, therefore, the feeling of hunger will not pursue so often. And here many people make a serious mistake: they begin to lean on cereals, whole grain pasta, dried fruits, nuts, vegetables. Yes, most likely you will actually start eating less. Fiber will provide you with the promised feeling of satiety. But the gastrointestinal tract will definitely not say thank you. We understand how the body reacts to an excess of dietary fiber.

Read also

You may start to suffer from constipation

Some people believe that constipation can only happen if the body lacks dietary fiber. But the reverse situation can also lead to such a problem – their excess. Food can stay in the intestines for 2 days. If you have eaten too much fiber, then “stagnation” occurs in it.

“Many people try to eat as much fiber as possible to lose weight, control cholesterol and blood sugar. However, if you do not drink more water, then the food will not move through the intestines at the proper speed. The result is abdominal pain and constipation,” say Eat This, Not that!

See also

Your stomach will swell

Excess fiber can harm not only the intestines, but also the stomach. Food will stagnate there, thereby provoking bloating.

The faster you eat, the more likely your stomach will become like a ball. Digestion is not a fast process, so you need to eat slowly, keeping the balance of proteins, fats and carbohydrates in a serving. This mindful approach will help you feel energized after eating and help your metabolism work faster.

See also

Another unpleasant consequence is diarrhea

Paradoxically, in some people, excess fiber can cause diarrhea. It all depends on the daily diet, physical activity. So, for example, when you get enough exercise and drink plenty of fluids, the abundance of fiber on the menu can have a laxative effect. A person will have diarrhea, he will suffer from flatulence.

Read also

Pro deficiency

An adult should eat 30 grams of fiber per day, based on the fact that in general his daily diet is about 2000 calories (that’s about 400 grams of foods containing dietary fiber). But many don’t even come close to that number.