Symptoms Associated With Dietary Fiber Supplementation Over Time in Individuals With Fecal Incontinence
Symptoms Associated With Dietary Fiber Supplementation Over Time in Individuals With Fecal Incontinence
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DOI：
10.1097/nnr.0b013e3182186d8c
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发表时间：
2011-05-01
期刊：
影响因子：
2.5
通讯作者：
Lowry, Ann
中科院分区：
文献类型：
--
作者：
Bliss, Donna Z.;Savik, Kay;Lowry, Ann
背景：关于纤维补充长期不良症状的知识缺乏。目的：本研究的目的是比较大便失禁的成年人在补充膳食纤维或安慰剂期间不良胃肠道（GI）症状的严重程度。第二个目的是确定症状严重程度和情绪不安之间的关系，以及它们与研究消耗和纤维剂量减少的关系。方法：患有大便失禁的参与者（N = 189； 77%女性；92%白人；年龄，M = 58岁，SD = 14岁）被随机分配到安慰剂组或每天补充16克膳食纤维的组，膳食纤维的来源有三种：阿拉伯胶、洋前子草或羧甲基纤维素。他们在基线期（14天）、递增纤维剂量期（6天）和2段稳定全纤维剂量期（总共32天）每天报告胃肠道症状。结果：所有组患者症状的严重程度均较轻。调整研究时间和时间，车前草组更大的饱腹感是唯一与安慰剂组不同的症状。与基线相比，稳定剂量段出现更严重的肠胃胀气、打嗝、饱腹和腹胀的几率是基线的1.2-2.0倍。症状严重程度与情绪不安之间存在正相关。饱腹感或腹胀感更强，或总体症状严重程度或情绪不安得分更高的参与者更有可能提前退出研究或减少纤维剂量。结论：随着时间的推移，大便失禁的人会经历各种胃肠道症状。症状严重程度和情绪不安似乎影响纤维耐受性和研究损耗。补充剂似乎耐受性良好。
Background: Knowledge about adverse symptoms over time from fiber supplementation is lacking.Purpose: The aim of this study was to compare the severity of adverse gastrointestinal (GI) symptoms during supplementation with dietary fiber or placebo over time in adults with fecal incontinence. A secondary aim was to determine the relationship between symptom severity and emotional upset and their association with study attrition and reducing fiber dose.Methods: Participants (N = 189; 77% female; 92% White; age, M = 58 years, SD = 14 years) with fecal incontinence were randomly assigned to a placebo or a supplement of 16 g total dietary fiber per day from 1 of 3 sources: gum arabic, psyllium, or carboxymethylcellulose. They reported GI symptoms daily during baseline (14 days), incremental fiber dosing (6 days), and 2 segments of steady full fiber dose (32 days total).Results: Severity of symptoms in all groups was minimal. Adjusting for study segment and day, a greater feeling of fullness in the psyllium group was the only symptom that differed from symptoms in the placebo group. The odds of having greater severity of flatus, belching, fullness, and bloating were 1.2-2.0 times greater in the steady dose segment compared with baseline. There was a positive association between symptom severity and emotional upset. Participants with a greater feeling of fullness or bloating or higher scores for total symptom severity or emotional upset were more likely to withdraw from the study sooner or reduce fiber dose.Conclusions: Persons with fecal incontinence experience a variety of GI symptoms over time. Symptom severity and emotional upset appear to influence fiber tolerance and study attrition. Supplements seemed well tolerated.