title: Can increased dietary fibre reduce laxative requirement in peritoneal dialysis patients?
abstract: Constipation is an important cause of technique failure and poor dialysis efficiency in Peritoneal Dialysis (PD) patients. A review of patient notes on our unit revealed 43% reported difficulties associated with constipation. A stool and laxative recording diary was sent to 126 PD patients. 46 patients reported using laxatives. All respondents using laxatives were invited to use a soluble dietary fibre supplement for 4 weeks, followed by dietary advice to see if they could achieve the same effect using high fibre foods. 23 patients entered the intervention stage of the study. 17 succeeded in replacing prescribed laxatives with the fibre supplement. 16 tried to increase their intake of high fibre foods, with 8 of these succeeding in improving their dietary intake of fibre; however only 2 were able to reduce their intake of fibre supplement. The results of the study suggest that a fibre supplement can be as effective as current laxative treatment in preventing constipation, as well as being the preferred choice of patients as many felt it improved bowel habits while not having the side effects of stimulant laxatives.
authors.affiliation: Wessex Renal and Transplant Service, Queen Alexandra Hospital, Portsmouth, UK. Debbie.sutton@porthosp.nhs.uk
authors.forename: Debbie
authors.initials: D
authors.lastname: Sutton
authors.forename: Susan
authors.initials: S
authors.lastname: Dumbleton
authors.forename: Claire
authors.initials: C
authors.lastname: Allaway
mesh_terms: D001294:Attitude to Health; D002755:Choice Behavior; D003248:Constipation / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D004043:Dietary Fiber / Q000008:administration & dosage* / Q000009:adverse effects / Q000032:analysis / Q000191:economics; D016527:Drug Costs; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D002149:Energy Intake; D004739:England; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D007792:Lactulose / Q000627:therapeutic use; D054368:Laxatives / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D018673:Nutrition Policy; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D012676:Senna Extract / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D004043:Dietary Fiber; D054368:Laxatives; D007792:Lactulose; D012676:Senna Extract