Fiber

The Effect of Fiber Supplementation on Chronic Constipation in Adults: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

van der Schoot A, Drysdale C, Whelan K, Dimidi E · The American journal of clinical nutrition · 2022 · n=1251

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. 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 (RCTs). Studies were identified using electronic databases, backward citation, and hand searches of abstracts. RCTs reporting administration of fiber supplementation in adults with chronic constipation were included. Risks of bias (RoB) was assessed with the Cochrane RoB 2.0 tool. Results were synthesized using risk ratios (RRs), mean differences, or standardized mean differences (SMDs) and 95% CIs using a random-effects model. Sixteen RCTs with 1251 participants were included. Overall, 311 of 473 (66%) participants responded to fiber

Chronic constipation: from pathophysiology to management.

Barbara G, Barbaro MR, Marasco G, Cremon C · Minerva gastroenterology · 2023

Chronic constipation (CC) is one of the most common conditions found in gastrointestinal clinical practice and defined by the presence of fewer than 3 bowel movements per week and/or more than one fourth of bowel movements with Bristol stool form types 1 or 2. CC affects people regardless of race, age, or sex, although it is most common in women and in elderly. It is associated with relevant disease burden, including significant impairment of patients' quality of life. In the absence of alarm features, patients should receive a symptom-based diagnosis. Treatment options include lifestyle and general measures, bulking agents, in particular dietary fiber supplementation. Osmotic laxatives are currently considered the first-line gold-standard pharmacological treatment of CC together with stimulant laxatives which are often used as a rescue therapy. When necessary, prokinetic agents and/or intestinal secretagogues can be used. Biofeedback may be indicated in patients with functional defeca

Mechanisms, Evaluation, and Management of Chronic Constipation.

Bharucha AE, Lacy BE · Gastroenterology · 2020

With a worldwide prevalence of 15%, chronic constipation is one of the most frequent gastrointestinal diagnoses made in ambulatory medicine clinics, and is a common source cause for referrals to gastroenterologists and colorectal surgeons in the United States. Symptoms vary among patients; straining, incomplete evacuation, and a sense of anorectal blockage are just as important as decreased stool frequency. Chronic constipation is either a primary disorder (such as normal transit, slow transit, or defecatory disorders) or a secondary one (due to medications or, in rare cases, anatomic alterations). Colonic sensorimotor disturbances and pelvic floor dysfunction (such as defecatory disorders) are the most widely recognized pathogenic mechanisms. Guided by efficacy and cost, management of constipation should begin with dietary fiber supplementation and stimulant and/or osmotic laxatives, as appropriate, followed, if necessary, by intestinal secretagogues and/or prokinetic agents. Peripher

[Diet and lifestyle rules in chronic constipation in adults: From fantasy to reality…].

Fathallah N, Bouchard D, de Parades V · Presse medicale (Paris, France : 1983) · 2017

Chronic constipation is one of the most common chronic gastrointestinal complaints and a frequent reason for consultation. Lifestyle modification and dietary advice attract a lot of patients, often dissatisfied with a long-term drug intake. These behavioral modifications are recommended as a first-line approach in the treatment of chronic mild constipation in the majority of current guidelines despite a low level of evidence. Fiber supplementation is probably the most relevant measure because of a satisfactory level of proof. It improves stool frequency and consistency. It has a positive effect on excessive straining and colonic transit time. The recommended daily fiber intake is at least 20 to 25g. To avoid side effects like bloating and abdominal pain, it must be gradually adjusted after a several days period. The benefice of increasing water intake or daily physical exercise in the treatment of chronic constipation have a lack of evidence, except specific situations such as elderly,

Sling-Fiber Preservation POEM vs. Conventional POEM for Reducing Post-POEM GERD: A Randomized Control Trial

n=120 · NCT07178821 · NOT_YET_RECRUITING · NOT_YET_RECRUITING

Peroral endoscopic myotomy (POEM) is an effective, minimally invasive treatment for achalasia, offering excellent rates of symptom relief. However, a significant drawback is the high incidence of gastroesophageal reflux disease (GERD) following the procedure. One proposed technical modification, the selective preservation of the sling fibers during gastric myotomy (SFP-POEM), may reduce this risk without compromising efficacy as compared to a conventional POEM procedure, which includes myotomy of the sling fibers. In this study, adults with achalasia will be randomly assigned to receive one of the two POEM technical approaches. Researchers will monitor whether preserving sling fibers reduces the rates of reflux esophagitis (classified as Los Angeles Grade B or higher) on follow-up endoscopy. Participants will be followed for up to 1 year after the procedure.

Fiber Supplementation and Metformin Combination Therapy in Adolescents With Severe Obesity and Insulin Resistance: Interactions With the Gut Microbiome.

n=90 · NCT04578652 · RECRUITING · RECRUITING

This is a 12-month, single center, three-arm parallel design, double-blind, randomized clinical trial, to compare the effects of supplemental dietary fiber and metformin (MET) alone and in combination over 12 months on glucose metabolism (insulin resistance \[IR\]), inflammation and BMI in adolescents with obesity and IR, and to assess the relationship between therapeutic intervention(s) and changes in gut microbiome composition and function. Since MET and FIBER have been shown to reduce weight and increase insulin sensitivity through distinct but overlapping mechanisms of action, our central hypothesis is that the combination of FIBER + MET will have a synergistic effect and be more effective than FIBER or MET alone in improving metabolic function (IR) and reducing BMI and inflammation in adolescents with obesity, IR and family history (FM) of T2DM. .

LASER Trial. LAparoscopic Elective Sigmoid Resection Following divERticulitis - a Multicenter, Prospective, Randomized Clinical Trial

n=133 · NCT02174926 · ACTIVE_NOT_RECRUITING · ACTIVE_NOT_RECRUITING

The purpose of this study is to find out whether elective sigmoid resection will improve quality of life compared to conservative treatment with lifestyle guidance and fiber supplement in patients with a recurrent or complicated diverticulitis.