Constipated? Consider a fibre supplement

If you’re among the one in four Canadians who suffer from constipation, you’re probably well aware that the condition can make you feel miserable: bloated, gassy, ​​lethargic and irritable.

For some people, constipation lasts for a short time, but for others it can last for weeks and months.

Recommendations for treating constipation emphasize increasing fiber intake, particularly through the use of a fiber supplement. But guidelines on the type, dose, and duration of fiber supplementation have been unclear.

Now, an updated review of studies, the largest review to date, provides evidence for optimal fiber supplementation regimens to improve chronic constipation.

What is chronic constipation?

Not having a daily bowel movement does not mean you are constipated. Medically speaking, constipation is defined as having fewer than three bowel movements per week.

Chronic constipation occurs when you have infrequent bowel movements, either hard, formed, or small stools, or difficulty having a bowel movement for several weeks or longer. The condition interferes with quality of life, affecting work and social relationships and mental well-being.

Research suggests that for half of people with chronic constipation, recommendations to increase fiber or use laxatives are ineffective or associated with uncomfortable side effects, such as bloating and gas.

latest research

The objective of the current investigation was to identify the optimal type of fiber supplement, dose, and duration of treatment for the management of chronic constipation. The analysis, published in the October issue of the American Journal of Clinical Nutrition, included 16 randomized controlled trials with 1,251 adult participants.

The researchers evaluated the effect of fiber supplements on bowel movement frequency, intestinal transit time (how long it takes for food to move through the intestine), as well as symptoms such as bloating, gas, abdominal pain, and straining. intense.

The studies used various types of fiber supplements, including psyllium powder, polydextrose powder, inulin, guar gum, pectin powder, and wheat bran. Doses ranged from four to 40 g per day and the duration of treatment lasted from two to eight weeks.

In general, fiber supplementation was effective in relieving constipation. The results showed that psyllium was the most effective, increasing the frequency of bowel movements by three per week, improving stool consistency, and decreasing the severity of straining.

When it came to supplement dosage and duration, fiber dosages greater than 10 g per day and treatment of at least four weeks were found to be optimal for controlling constipation.

The study also found that fiber supplements worsened flatulence, especially supplements that contained inulin. Inulin, a prebiotic fiber derived from chicory root, is fermented by intestinal bacteria; consuming high doses can cause gas and bloating.

Fiber Supplement Considerations

Before you start taking a fiber supplement, review your medications with your pharmacist. Fiber supplements can decrease the absorption of certain medications, including those used to treat thyroid disorders, depression, and type 2 diabetes.

Start slowly to avoid digestive upset. Start with the lowest recommended dose and gradually increase the amount of fiber.

Take a fiber supplement with at least 250 ml of water to improve effectiveness and prevent side effects. Be consistent; take your fiber supplement daily.

Don’t overlook dietary fiber

Try to get most of your daily fiber from whole foods, which contain several types of fiber (many fiber supplements provide only one type) along with protective nutrients and phytochemicals.

In addition to promoting digestive health, a high-fiber diet is linked to a lower risk of type 2 diabetes, cardiovascular disease, and certain cancers.

The daily fiber recommendations for adults, ages 19 to 50, are 38 g (men) and 25 g (women). Men and women over the age of 50 require 30 and 21 g per day, respectively.

Whole grains, fruits, vegetables, legumes, nuts, and seeds contain two types of fiber in varying amounts: soluble and insoluble fiber.

Soluble fiber dissolves in water and forms a gel-like material during digestion. Helps reduce blood sugar and cholesterol levels. Good sources include oats, oat bran, psyllium husks, barley, beans and lentils, citrus fruits, pears, apples, and chia seeds.

Insoluble fiber remains largely intact as it passes through the digestive tract. This type of fiber adds bulk to the stool, promoting regularity. Wheat bran, whole wheat pasta, whole rye bread, pinto beans, walnuts, sweet potatoes, kale, peas, and raspberries are examples of foods high in insoluble fiber.

Leslie Beck, a Toronto-based dietitian in private practice, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD