Abstract
- Background
Chronic constipation is a prevalent disorder that remains challenging to treat. Studies suggest increasing fiber intake may improve symptoms, although recommendations on the fiber type, dose, and treatment duration are unclear.
- Objectives
We investigated the effects of fiber supplementation on stool output, gut transit time, symptoms, and quality of life in adults with chronic constipation via a systematic review and meta-analysis of randomized controlled trials.
- Methods
Studies were identified using electronic databases, backward citation, and hand searches of abstracts. Randomized controlled trials reporting administration of fiber supplementation in adults with chronic constipation were included. Risks of bias were assessed with the Cochrane tool, and results were synthesized using risk ratios, mean differences, or standardized mean differences and confidence intervals.
- Results
Sixteen trials with 1251 participants were included. Overall, 66% of participants responded to fiber treatment compared to 41% in control groups, with psyllium and pectin having significant effects. A higher response was apparent with higher fiber doses exceeding 10 grams per day. Fiber increased stool frequency, with psyllium and pectin showing significant effects only with higher doses and treatment durations of at least 4 weeks. Fiber improved stool consistency, particularly at higher doses, while flatulence was higher in fiber groups compared to controls.
- Conclusions
Fiber supplementation is effective at improving constipation. Particularly, psyllium, doses exceeding 10 grams per day, and treatment durations of at least 4 weeks appear optimal, though caution is needed when interpreting the results due to considerable heterogeneity. These findings provide promising evidence on the optimal type and regime of fiber supplementation, which could be used to standardize recommendations to patients.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9535527/