If you’re one in four Canadians who suffer from constipation, you probably know that the condition can make you feel miserable – bloating, gas, lethargy and irritability.
For some people, constipation only lasts a short time, but for others it can last for weeks and months.
Constipation treatment recommendations emphasize increasing your fiber intake, particularly with fiber supplements. But guidelines for the type, dosage, and duration of fiber supplements were not clear.
Now, an updated review of studies – the largest to date – provides evidence of optimal fiber supplementation guidelines for improving chronic constipation.
What is chronic constipation?
Not having a daily bowel movement does not mean that 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 — whether hard, shaped or small stools — or difficulty passing stools for several weeks or longer. The condition interferes with quality of life, affecting work, 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 linked to uncomfortable side effects such as bloating and gas.
The aim of the current research was to determine 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 involving 1,251 adult participants.
The researchers evaluated the effect of fiber supplementation on the frequency of bowel movements, bowel transit time (that is, how long it takes food to travel through the gut), as well as symptoms such as bloating, gas, abdominal pain and severity of fatigue.
Studies have used different types of fiber supplements, including psyllium powder, polydextrose powder, inulin, guar gum, pectin powder, and wheat bran. Doses ranged from 4 to 40 grams per day and treatment periods lasted from two to eight weeks.
In general, fiber supplements were effective in relieving constipation. The results showed that psyllium was the most effective, increasing bowel movement frequency by three per week, improving stool consistency and reducing stress intensity.
When it comes to supplement dosage and duration, fiber doses greater than 10g per day and treatment for at least four weeks are optimal for constipation control.
The study also found that fiber supplements exacerbated flatulence, especially insulin-containing supplements. Inulin, a prebiotic fiber derived from dandelion roots, is fermented by gut bacteria. Taking high doses can lead to gas and bloating.
Fiber Supplement Considerations
Before you start taking a fiber supplement, review your medications with your pharmacist. Fiber supplements can reduce the absorption of some medications, including those used to treat thyroid disorders, depression, and type 2 diabetes.
Start slowly to prevent digestive discomfort. Start with the lowest recommended dose and gradually increase the amount of fiber.
Take a fiber supplement with at least 250ml of water to enhance effectiveness and prevent side effects. be consistent; Take a fiber supplement daily.
Do not overlook dietary fiber
Try to get most of your daily fiber from whole foods, which contain different types of fiber (many fiber supplements provide only one type) along with nutrients and protective phytochemicals.
Besides promoting digestive health, a high-fiber diet is associated with a lower risk of type 2 diabetes, cardiovascular disease, and some types of cancer.
The daily fiber recommendations for adults, ages 19 to 50, are 38 grams (for males) and 25 grams (for females). Men and women over 50 need 30 and 21 grams per day, respectively.
Whole grains, fruits, vegetables, legumes, nuts, and seeds contain two types of fiber in varying amounts: soluble and insoluble.
Soluble fiber dissolves in water and forms a gel-like substance during digestion. Helps reduce blood sugar and cholesterol levels. Good sources include oats, oat bran, psyllium husks, barley, beans, lentils, citrus fruits, pears, apples, and chia seeds.
Insoluble fiber remains largely intact as it passes through the digestive system. This type of fiber adds bulk to the stool, promoting regularity. Examples of foods rich in insoluble fiber include wheat bran, whole-wheat pasta, rye bread, whole grains, pinto beans, nuts, sweet potatoes, kale, green peas, and berries.
Leslie Beck, a Toronto-based private dietitian, is Medcan’s director of food and nutrition. Follow her on Twitter Tweet embed