Clinical response to dietary fiber treatment of chronic constipation.
OBJECTIVE
To determine the clinical outcome of dietary fiber therapy in patients with chronic constipation.


METHODS
One hundred, forty-nine patients with chronic constipation (age 53 yr, range 18-81 yr, 84% women) at two gastroenterology departments in Munich, Germany, were treated with Plantago ovata seeds, 15-30 g/day, for a period of at least 6 wk. Repeated symptom evaluation, oroanal transit time measurement (radiopaque markers), and functional rectoanal evaluation (proctoscopy, manometry, defecography) were performed. Patients were classified on the basis of the result of dietary fiber treatment: no effect, n = 84; improved, n = 33; and symptom free, n = 32.


RESULTS
Eighty percent of patients with slow transit and 63% of patients with a disorder of defecation did not respond to dietary fiber treatment, whereas 85% of patients without a pathological finding improved or became symptom free.


CONCLUSIONS
Slow GI transit and/or a disorder of defecation may explain a poor outcome of dietary fiber therapy in patients with chronic constipation. A dietary fiber trial should be conducted before technical investigations, which are indicated only if the dietary fiber trial fails.
Voderholzer
W A
WA
Medizinische Klinik, Klinikum Innenstadt, University of Munich, Germany.
Schatke
W
W
Mühldorfer
B E
BE
Klauser
A G
AG
Birkner
B
B
Müller-Lissner
S A
SA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003248:Constipation / Q000178:diet therapy*; D004043:Dietary Fiber / Q000008:administration & dosage*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome