Fiber and functional gastrointestinal disorders

Am J Gastroenterol. 2013 May;108(5):718-27. doi: 10.1038/ajg.2013.63. Epub 2013 Apr 2.

Abstract

Despite years of advising patients to alter their dietary and supplementary fiber intake, the evidence surrounding the use of fiber for functional bowel disease is limited. This paper outlines the organization of fiber types and highlights the importance of assessing the fermentation characteristics of each fiber type when choosing a suitable strategy for patients. Fiber undergoes partial or total fermentation in the distal small bowel and colon leading to the production of short-chain fatty acids and gas, thereby affecting gastrointestinal function and sensation. When fiber is recommended for functional bowel disease, use of a soluble supplement such as ispaghula/psyllium is best supported by the available evidence. Even when used judiciously, fiber can exacerbate abdominal distension, flatulence, constipation, and diarrhea.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / etiology
  • Constipation* / diet therapy
  • Constipation* / etiology
  • Constipation* / physiopathology
  • Diarrhea / etiology
  • Dietary Fiber / administration & dosage
  • Dietary Fiber / adverse effects
  • Dietary Fiber / metabolism*
  • Dietary Fiber / therapeutic use*
  • Evidence-Based Medicine
  • Fermentation
  • Flatulence / etiology
  • Gastrointestinal Diseases / diet therapy*
  • Gastrointestinal Diseases / etiology*
  • Gastrointestinal Diseases / metabolism
  • Humans
  • Irritable Bowel Syndrome / diet therapy
  • Irritable Bowel Syndrome / etiology
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Treatment Outcome