停止或减少膳食纤维的摄入可减少便秘及其相关症状。
Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms.
机构信息
Seow-Choen Colorectal Surgery PLC, Singapore 238859, Singapore.
出版信息
World J Gastroenterol. 2012 Sep 7;18(33):4593-6. doi: 10.3748/wjg.v18.i33.4593.
AIM
To investigate the effect of reducing dietary fiber on patients with idiopathic constipation.
METHODS
Sixty-three cases of idiopathic constipation presenting between May 2008 and May 2010 were enrolled into the study after colonoscopy excluded an organic cause of the constipation. Patients with previous colon surgery or a medical cause of their constipation were excluded. All patients were given an explanation on the role of fiber in the gastrointestinal tract. They were then asked to go on a no fiber diet for 2 wk. Thereafter, they were asked to reduce the amount of dietary fiber intake to a level that they found acceptable. Dietary fiber intake, symptoms of constipation, difficulty in evacuation of stools, anal bleeding, abdominal bloating or abdominal pain were recorded at 1 and 6 mo.
RESULTS
The median age of the patients (16 male, 47 female) was 47 years (range, 20-80 years). At 6 mo, 41 patients remained on a no fiber diet, 16 on a reduced fiber diet, and 6 resumed their high fiber diet for religious or personal reasons. Patients who stopped or reduced dietary fiber had significant improvement in their symptoms while those who continued on a high fiber diet had no change. Of those who stopped fiber completely, the bowel frequency increased from one motion in 3.75 d (± 1.59 d) to one motion in 1.0 d (± 0.0 d) (P < 0.001); those with reduced fiber intake had increased bowel frequency from a mean of one motion per 4.19 d (± 2.09 d) to one motion per 1.9 d (± 1.21 d) on a reduced fiber diet (P < 0.001); those who remained on a high fiber diet continued to have a mean of one motion per 6.83 d (± 1.03 d) before and after consultation. For no fiber, reduced fiber and high fiber groups, respectively, symptoms of bloating were present in 0%, 31.3% and 100% (P < 0.001) and straining to pass stools occurred in 0%, 43.8% and 100% (P < 0.001).
CONCLUSION
Idiopathic constipation and its associated symptoms can be effectively reduced by stopping or even lowering the intake of dietary fiber.
目的
研究减少膳食纤维对特发性便秘患者的影响。
方法
2008 年 5 月至 2010 年 5 月间，结肠镜排除便秘的器质性原因后，纳入 63 例特发性便秘患者。排除既往结肠手术或有医学原因导致便秘的患者。所有患者均解释膳食纤维在胃肠道中的作用。然后，嘱其进行 2 周无纤维饮食。此后，嘱其减少膳食纤维的摄入量，直至其认为可接受的水平。分别在 1 个月和 6 个月时记录膳食纤维摄入量、便秘症状、排便困难、肛门出血、腹胀或腹痛。
结果
患者的中位年龄（16 名男性，47 名女性）为 47 岁（范围，20-80 岁）。6 个月时，41 例患者继续无纤维饮食，16 例患者继续低纤维饮食，6 例患者因宗教或个人原因恢复高纤维饮食。停止或减少膳食纤维的患者症状明显改善，而继续高纤维饮食的患者则无变化。完全停止纤维饮食的患者排便频率从 3.75 天 1 次（±1.59 天）增加到 1 天 1 次（±0.0 天）（P<0.001）；减少纤维摄入的患者排便频率从平均 4.19 天 1 次（±2.09 天）增加到低纤维饮食时的平均 1.9 天 1 次（±1.21 天）（P<0.001）；继续高纤维饮食的患者咨询前后排便频率分别为平均 6.83 天 1 次（±1.03 天）。无纤维、低纤维和高纤维组的腹胀症状分别为 0%、31.3%和 100%（P<0.001），排便费力分别为 0%、43.8%和 100%（P<0.001）。
结论
通过停止甚至降低膳食纤维的摄入，可有效减轻特发性便秘及其相关症状。
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