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Is Fiber the Answer? Researchers Doubt It
NY Times ^ | January 18, 2005 | NICHOLAS BAKALAR

Posted on 01/21/2005 8:36:54 PM PST by neverdem

Despite the barrage of television commercials that insist otherwise, a diet low in fiber is usually not the cause of constipation, and taking fiber supplements is probably not the cure, according to a new study.

In fact, a fiber supplement can actually make symptoms worse in some patients, particularly the most severely afflicted. A review study published in the January issue of The American Journal of Gastroenterology suggests that many other common beliefs about constipation are also little more than durable myths.

According to the American College of Gastroenterology, constipation is the reason for at least 2.5 million doctor visits annually in the United States, and ACNielsen, the marketing information company, reports that Americans spent more than $700 million last year on over-the-counter laxative medicines. Yet much of the advice they got - including many suggestions from doctors - was probably not helpful.

Fiber is far from a panacea. In one study, fewer than half of the patients with self-described constipation had any response to added fiber, and studies comparing people with chronic constipation to comparison groups without the condition show no difference in their dietary fiber intake.

At best, a diet low in fiber may be a contributory factor in a minority of patients, and fiber supplements may help them, the reviewers, led by Dr. Stefan Müller-Lissner, a professor of medicine at Humboldt University in Berlin, found.

Drinking more liquid is often recommended, but studies show it does not work. Although it may seem that adding water to hard stools will soften them, adding liquid does not accomplish this, nor does it relieve constipation.

If fiber and liquids do not help much, will increasing exercise? The studies say no.

Despite its other benefits, exercise is largely ineffective in preventing constipation. It seems to help in the elderly if it is part of a broader program, but it does not work in young, severely constipated patients. While workouts like marathons can increase gut activity, moderately increased exercise in healthy people has no discernible effect on bowel function.

What really works for constipation? "I do start with a trial of dietary fiber," Dr. Müller-Lissner said. "Prunes and other fruits may be effective, although bloating can occur as a side effect."

If those measures do not work, Dr. Müller-Lissner recommends laxatives. In addition to the fiber additives, there are three other types: stool softeners (Colace, for example); saline laxatives like milk of magnesia; and stimulant laxatives, including Dulcolax, Correctol, and others. "I prescribe macrogol," the active ingredient in Colace and many other brands, he said.

He added, "If this is ineffective or not tolerated, I switch to bisacodyl" in Correctol and other stimulants, "or a related compound."

These drugs are not harmful in normal dosages, Dr. Müller-Lissner said. Some experts believe that stimulant laxatives that amplify bowel motility can increase the risk for colorectal cancer, but the evidence is weak. Chronic constipation is itself associated with an increased risk of the cancer, but no evidence supports a belief that laxatives used in recommended doses increase the risk.

Other doctors suspect that the drugs have a host of adverse side effects - that they can be psychologically habit-forming, that they cause physical physical dependence, that they lead to "rebound" constipation, or that they damage the nerves and muscles that control the bowel. But studies have found no evidence.

Dr. Müller-Lissner says he believes that what constitutes a normal frequency of bowel movements is up to the patient. "The statistical range of normality is from three stools a day to three stools a week," he said. "But in clinical terms, this is irrelevant. If there is no organic disease underlying the constipation, a low stool frequency by itself does no harm. The only motivation for treatment is the patient's complaint."


TOPICS: Business/Economy; Culture/Society; Extended News; Germany; News/Current Events
KEYWORDS: constipation; fiber; health; medicine
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1 posted on 01/21/2005 8:36:55 PM PST by neverdem
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To: neverdem

Just damn


2 posted on 01/21/2005 8:38:54 PM PST by B.O. Plenty
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To: neverdem

Oh, Thank God there's a reason I always hated being down-wind......


3 posted on 01/21/2005 8:41:43 PM PST by Smarti Pants (~This American Patriot will never forget !!!~)
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To: neverdem
What works for my 69 year old digestive system is .....are you ready ....Cantaloupe.

And if that doesn't work....MiraLax...prescription but very "kind".....

An alternative is decreasing my intake of fine wines which are very dehyrative....an alternative which I have not yet given the time of day!

4 posted on 01/21/2005 8:47:18 PM PST by HardStarboard (PASS)
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To: neverdem

5 posted on 01/21/2005 8:48:13 PM PST by Constitution Day
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To: neverdem

I saw the headline and thought this had to do with Internet access. Since it's the other kind of fiber, I might add that fiber sure worked for me!!


6 posted on 01/21/2005 8:50:00 PM PST by SolidRedState (Free Martha)
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To: neverdem

Well, considering the subject of the article, this is probably a good place to share some very useful info:

http://www.nexttonature.com/

I have absolutely no connection to the above. I recently came across it, ordered a free sample for an old lady I know, who tried just about every over the counter and prescription medication to relieve her constipation and nothing really worked well, until this. It is some specially prepared aloe vera, I wasn't sure it would work, this lady was also very sceptical, but tried it, and it totally alleviated her problem, and it's all natural. And can be taken long term.

I wouldn't have believed it, but it worked for her, after she tried literally everything else without any real success. I think it's worth a try for anyone having a problem.

I may order some, just to keep it around, for possible occasional need.


7 posted on 01/21/2005 8:50:18 PM PST by FairOpinion
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To: El Gato; JudyB1938; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; tiamat; PGalt; ..

FReepmail me if you want on or off my health and science ping list.


8 posted on 01/21/2005 8:51:53 PM PST by neverdem (May you be in heaven a half hour before the devil knows that you're dead.)
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To: neverdem
These work for me.


9 posted on 01/21/2005 8:51:55 PM PST by Fitzcarraldo
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Comment #10 Removed by Moderator

To: Constitution Day

LOL!!! I could almost swear that Phoebe Snow sang the jingle on that SNL skit ( "Colon Blow and you-u-u-u in the morning").


11 posted on 01/21/2005 8:53:04 PM PST by avenir
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To: FairOpinion

Prune Juice works and is used in hospitals and nursing homes all over the place. It DOES work! It's also high in iron.


12 posted on 01/21/2005 8:55:13 PM PST by Nuzcruizer
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To: neverdem

It's more likely the OTHER foods besides the FIBER that are causing the problems......sheesh. In other words, decrease white bread, sugar, white rice, etc.....increase green and red vegetables, and add a little psyllium to the daily diet, too!


13 posted on 01/21/2005 9:00:02 PM PST by goodnesswins (Tax cuts, Tax reform, social security reform, Supreme Court, etc.....the next 4 years.....)
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To: neverdem

Refried beans and kim chee. It churns things up inside, but it cleans you out.


14 posted on 01/21/2005 9:02:35 PM PST by elmer fudd
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To: neverdem

There's always cascara. It's been used for years. Supposedly mild.


15 posted on 01/21/2005 9:02:56 PM PST by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: neverdem

There's always cascara. It's been used for years. Supposedly mild.


16 posted on 01/21/2005 9:03:04 PM PST by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: Doctor Stochastic

The Internet seems so stopped up that I must have hit the post button twice.


17 posted on 01/21/2005 9:04:56 PM PST by Doctor Stochastic (Vegetabilisch = chaotisch is der Charakter der Modernen. - Friedrich Schlegel)
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To: Fitzcarraldo

How long does it take to eat that many apples?


18 posted on 01/21/2005 9:06:17 PM PST by SolidRedState (Free Martha)
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To: Constitution Day

I remember that one! Hilarious!


19 posted on 01/21/2005 9:06:47 PM PST by vpintheak (Liberal = The antithesis of Freedom and Patriotism)
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To: neverdem

Hmmm.... Ever been stuck in morning traffic after scarfing down a bran muffin and half a pot of coffee?


20 posted on 01/21/2005 9:10:15 PM PST by Lancey Howard
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