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Fiber Therapy For Constipation

The average American eats only 10 to 15 grams (g) of fiber daily (Slavin 1987). Typical recommendations are 20 to 35 g of dietary fiber daily (Marlett 2002). Fiber is excellent for overall intestinal health and alleviating chronic constipation. Although humans cannot digest fiber, the 5 pounds of friendly bacteria present in our digestive tract use fiber for fermentation and production of useful short-chain fatty acids that the cells of the intestine use for energy.

Most foods contain a mixture of soluble and insoluble fiber. Both are important in treating constipation. Soluble fiber is contained in oats, apples, lentils, barley, breads, and cereals. It is able to mix evenly with water, forming a soft gel. Insoluble fiber is contained in raw wheat bran, other whole grains, fruits and vegetables. It mixes unevenly with water, forming a soft pulp. The body does not absorb soluble or insoluble fiber during digestion. Fiber contributes volume to the stool mass, making it easier for the colon to push and propel larger and softer stools out of the body. Insoluble fiber encourages contraction of the colon.

Both fiber types contribute volume to individual stool masses. A larger mass of stool is easier for the colon to push against and propel, so larger, softer stools are easier to move and pass.

The following supplements may succeed at moving the bowels when regular fiber supplements fail to correct chronic constipation:

Chitosan. Chitosan is a fiber composed of chitin, a component of the shell of shellfish. Chitosan has the ability to bind fat from food in the stomach and the intestines. When fat content in the bowel increases, it makes the feces soft and smooth. If you do not obtain results from other commonly used fiber sources, six 500-milligram (mg) capsules of chitosan along with 1,000 mg of vitamin C before each meal may help alleviate constipation. Ascorbic acid (vitamin C) helps transform chitosan in the stomach and intestine into a fat-absorbing gel. Chitosan should not be used by people who have shellfish allergies.

Glucomannan. Glucomannan is a water-soluble dietary fiber derived from the konjac root (Amorphophallus konjac). Glucomannan is considered a bulk-forming laxative that promotes a larger, bulkier stool (Marsicano 1995). Glucomannan generally helps produce a bowel movement within 12 to 24 hours.

Constipation is frequently encountered during pregnancy. A preparation of lactulose and glucomannan is effective and well-tolerated in pregnant women. Pregnant women with constipation who were treated with a preparation of 3 to 6 g of glucomannan and 8 to 16 g of lactulose twice daily for 1 to 3 months showed a return of normal frequency of evacuations. The formula also helped control weight gain (Signorelli 1996).

In one study, laxative use was significantly reduced in a long-term care facility when an interdisciplinary program was implemented based on prevention and health promotion. Specifically, increased fluid and fiber intake, timely toileting habits, and regular activity or exercise led to a 50 percent reduction in the number of patients receiving laxatives (Benton 1997).