title: Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms.
abstract: OBJECTIVE
  To investigate the effect of reducing dietary fiber on patients with idiopathic constipation.
  
  
  METHODS
  Sixty-three cases of idiopathic constipation presenting between May 2008 and May 2010 were enrolled into the study after colonoscopy excluded an organic cause of the constipation. Patients with previous colon surgery or a medical cause of their constipation were excluded. All patients were given an explanation on the role of fiber in the gastrointestinal tract. They were then asked to go on a no fiber diet for 2 wk. Thereafter, they were asked to reduce the amount of dietary fiber intake to a level that they found acceptable. Dietary fiber intake, symptoms of constipation, difficulty in evacuation of stools, anal bleeding, abdominal bloating or abdominal pain were recorded at 1 and 6 mo.
  
  
  RESULTS
  The median age of the patients (16 male, 47 female) was 47 years (range, 20-80 years). At 6 mo, 41 patients remained on a no fiber diet, 16 on a reduced fiber diet, and 6 resumed their high fiber diet for religious or personal reasons. Patients who stopped or reduced dietary fiber had significant improvement in their symptoms while those who continued on a high fiber diet had no change. Of those who stopped fiber completely, the bowel frequency increased from one motion in 3.75 d (± 1.59 d) to one motion in 1.0 d (± 0.0 d) (P < 0.001); those with reduced fiber intake had increased bowel frequency from a mean of one motion per 4.19 d (± 2.09 d) to one motion per 1.9 d (± 1.21 d) on a reduced fiber diet (P < 0.001); those who remained on a high fiber diet continued to have a mean of one motion per 6.83 d (± 1.03 d) before and after consultation. For no fiber, reduced fiber and high fiber groups, respectively, symptoms of bloating were present in 0%, 31.3% and 100% (P < 0.001) and straining to pass stools occurred in 0%, 43.8% and 100% (P < 0.001).
  
  
  CONCLUSIONS
  Idiopathic constipation and its associated symptoms can be effectively reduced by stopping or even lowering the intake of dietary fiber.
authors.affiliation: Seow-Choen Colorectal Surgery PLC, Singapore 238859, Singapore.
authors.forename: Kok-Sun
authors.initials: KS
authors.lastname: Ho
authors.forename: Charmaine You Mei
authors.initials: CY
authors.lastname: Tan
authors.forename: Muhd Ashik
authors.initials: MA
authors.lastname: Mohd Daud
authors.forename: Francis
authors.initials: F
authors.lastname: Seow-Choen
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D003248:Constipation / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D004043:Dietary Fiber / Q000009:adverse effects; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000453:epidemiology / Q000209:etiology / Q000628:therapy