Impact of Fiber Fermentation on Fecal Incontinence

纤维发酵对大便失禁的影响

• 批准号: 7029724
• 负责人: DONNA Z BLISS
• 金额: $ 50.42万
• 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/7029724
• 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（由申请人提供）：大便失禁（FI），即粪便不自觉地漏出，是一个对健康和福祉造成衰弱影响的慢性问题。 FI 症状管理对于维护个人的尊严、自尊和健康、减轻护理人员的负担以及防止进入疗养院至关重要。 稀便/液体粪便稠度会加剧 FI，其处理的第一步是使粪便稠度变硬。 拟议的研究解决了 FI 临床管理中的一个主要空白，因为缺乏对 FI 粪便硬度的干预措施的研究。 纤维对粪便稠度和 FI 的有益影响似乎与纤维的发酵程度有关。 优化纤维疗法和改善临床反应的关键步骤是确定纤维发酵的重要性。 本研究的长期目标是 1) 制定使用可溶性膳食纤维有效管理 FI 的循证建议，2) 确定可溶性膳食纤维改善粪便稠度和 FI 的机制。 该提案的目的是确定发酵对纤维巩固粪便稠度、减少粪便稠度、促进补充剂耐受性以及改善患有稀便或液体粪便的社区成年人的生活质量的影响。 将使用随机、受控、单盲组间设计。 After a 2 wk.基线期间，184 名患有稀便/液状粪便的社区生活成年人将被随机分配接受安慰剂或每天 16 克阿拉伯胶、洋车前子或羧甲基纤维素中的总纤维，代表三种发酵能力水平（分别为完全发酵、中等发酵和不可发酵）。 在基线期间和补充期结束时，受试者将完成粪便日记（14天）、饮食记录（7天）、FI生活质量调查，并收集所有粪便（7天）。 使用ANCOVA 控制这些测量值的基线值后，将比较补充后各组测量值之间的差异。