Impact of Fiber Fermentation on Fecal Incontinence

纤维发酵对大便失禁的影响

• 批准号: 6751579
• 负责人: DONNA Z BLISS
• 金额: $ 50.94万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-06-01 至 2008-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6751579
• 关键词: adult human (21+); clinical research; diet therapy; dietary fiber; dietary supplements; fecal incontinence; feces; feces analysis; fermentation; gastrointestinal gas; gastrointestinal sign /symptom; human subject; human therapy evaluation; methylcellulose; nursing research; patient oriented research; personal log /diary; plant extracts; polysaccharides; quality of life; taste; technology /technique development; therapy compliance

DESCRIPTION (provided by applicant): Fecal incontinence (FI), the involuntary leakage of feces, is a chronic problem with debilitating effects on health and well-being. Symptom management of FI is essential to maintain the dignity, self-esteem, and health of the individual, ease the burden of caregivers, and prevent admission to a nursing home. FI is worsened by loose/liquid stool consistency and the first step in its management is to firm stool consistency. The proposed study addresses a major gap in clinical management of FI since there is a lack of research on interventions to firm stool consistency in FI. The beneficial effects of fiber on stool consistency and FI appear to be related to the extent to which the fiber is fermented. A pivotal step in optimizing fiber therapy and improving the clinical response is to determine the importance of fermentation of fiber. The long-range objectives of this research are 1) to develop evidenced-based recommendations for using soluble dietary fiber to effectively manage FI and 2) to determine the mechanisms by which soluble dietary fiber improves stool consistency and FI. The objectives of this proposal are to determine the impact of fermentation on a fiber's ability to firm stool consistency, reduce FI, promote supplement tolerance, and improve quality of life in community-living adults with FI of loose or liquid stools. A randomized, controlled, single blind between groups design will be used. After a 2 wk. Baseline period, 184 community-living adults with FI of loose/liquid stool will be randomized to receive placebo or 16 g of total fiber/d in gum Arabic, psyllium, or carboxy-methylcellulose, representing three levels of ferment ability (completely, moderately, and non-fermentable, respectively). During the baseline and at the end of the supplementation period, subjects will complete a stool diary (14d), diet record (7d), FI Quality of Life survey, and collect all stools (7d). Differences among the measures of the groups after supplementation will be compared after controlling for baseline values of these measures using ANCOVA.

描述(申请人提供)：大便失禁(FI)，排泄物的非自愿渗漏，是一种慢性问题，对健康和福祉造成衰弱影响。FI的症状管理对于维护个人的尊严、自尊和健康，减轻照顾者的负担，防止进入养老院至关重要。松散/液体大便的一致性会使FI恶化，其管理的第一步是确保大便的一致性。这项拟议的研究解决了FI临床管理中的一个主要空白，因为缺乏关于FI中确保粪便一致性的干预措施的研究。纤维对大便稠度和FI的有益影响似乎与纤维发酵的程度有关。确定纤维发酵的重要性是优化纤维治疗和提高临床疗效的关键一步。这项研究的长期目标是：1)开发基于证据的使用可溶性膳食纤维有效管理FI的建议；2)确定可溶性膳食纤维改善大便稠度和FI的机制。这项建议的目的是确定发酵对纤维的能力的影响，以巩固大便的一致性，减少FI，促进补充耐受性，并提高社区生活的成年人的生活质量，FI是疏松或液体的。将采用随机、对照、组间单盲设计。2周后。在基准期内，184名有疏松/液体大便FI的社区生活成年人将随机接受安慰剂或16克阿拉伯树胶、木耳或羧甲基纤维素总纤维/d，分别代表三种发酵能力水平(分别为完全、中度和不可发酵)。在基线和补充期结束时，受试者将完成大便日记(14d)、饮食记录(7d)、FI生活质量调查，并收集所有大便(7d)。在使用ANCOVA对这些指标的基线值进行控制后，将比较补充后各组指标之间的差异。