Fiber, dietary constipation

Prior to this work, dietary fiber, of which ceUulose is oae of the more important constituents, was considered important primarily as a means of preventing or overcoming constipation. Otherwise, dietary fiber was considered to be a metaboHcally iaert substance. A large variety of diseases such as appendicitis, hiatus hernia, gallstones, ischemic heart disease, diabetes, obesity, dental caries, and duodenal ulcers are now suspected to be associated with the consumption of a highly refined diet (42). 

OILE ACID SEQUESTRANTS. Fhtients taking the antihyperlipidemic dragp, particularly the bile acid sequestrants, may experience constipation. The dragp can produce or severely worsen preexisting constipation. The nurse instructs the patient to increase fluid intake, eat foods high in dietary fiber, and exercise daily to help prevent constipation. If the problem persists or becomes... 

Substantial individual differences were observed in the response to study breads and the ranges of enterolactone concentration changes in the groups were as follows -54.5-60.0 nmol/1 (placebo), -26.2-101.3 nmol/1 (LP), -19.6-81.8 nmol/1 (HP). This was something that could have been expected as in several studies dietary factors have explained only 10% of the variation in serum enterolactone (Vanharanta et al, 2002b Kilkkinen et al., 2001). This gives further support to the major role of intestinal bacteria in the synthesis of enterolactone. Decreased concentrations of enterolactone may occur due to an increased fiber intake, which may shorten the retention time in the colon and lead to incomplete metabolism of plant lignans. Constipation was earlier shown to be associated with an increased level of serum enterolactone (Kilkkinen et al., 2001). 

Colesevelam 625 mg tablets 3750-4375 mg/day as a single dose or divided twice daily, with meals colesevelam. Increasing fluid and dietary fiber intake may relieve constipation and bloating. Impair absorption of fat-soluble vitamins. 

Constipation is the most common adverse reaction it can be treated with increased water intake, dietary fiber (given separately from calcium), and exercise. Calcium carbonate can create gas, sometimes causing flatulence or upset stomach. 

Increased intake of soluble fiber in the form of oat bran, pectins, certain gums, and psyllium products can result in useful adjunctive reductions in total and LDL cholesterol (5% to 20%), but these dietary alterations or supplements should not be substituted for more active forms of treatment. They have little or no effect on HDL-C or triglyceride concentrations. These products may also be useful in managing constipation associated with the bile acid resins (BARs). 

General measures believed to be beneficial in managing constipation include dietary modification to increase the amount of fiber consumed daily, exercise, adjustment of bowel habits so that a regular and adequate time is made to respond to the urge to defecate, and increasing fluid intake. 

The most important aspect of the therapy for constipation for the majority of patients is dietary modification to increase the amount of fiber consumed. Patients should be advised to include at least 10 g of crude fiber in their daily diets. Fruits, vegetables, and cereals have the highest fiber content. 

The basis for treatment and prevention of constipation should consist of bulk-forming agents in addition to dietary modifications that increase dietary fiber. 

It is unlikely that these agents are effective in preventing constipation if major causative factors (e.g., heavy opiate use, uncorrected pathology, inadequate dietary fiber) are not concurrently addressed. 

Constipation commonly occurs during pregnancy. Nondrug modalities such as education, physical exercise, biofeedback, and increased intake of dietary fiber and fluid should be instituted first. 

Constipation can be treated with increases in exercise, fluid, and dietary fiber intake. 

Calcium Acetate (PhosLo) [Calcium Supplement/ Anti arrhythmic/Mmeral/ Electrolyte] Uses ESRD-associated hyper-phos-phatemia Action Ca " supl w/o aluminum to X P04 absorption Dose 2-4 tabs PO w/ meals Caution [C, ] Contra t Ca Disp Gelcap SE Can t Ca, hypophosphatemia, constipation Interactions t Effects OF quinidine X effects W/ large intake of dietary fiber, spinach, rhubarb X effects OF atenolol, CCB, etidronate, tetracyclines, fluoroquinolones, phenytoin, Fe salts, thyroid hormones EMS Pts have reduced renal Fxn, monitor ECG for signs of electrolyte disturbances OD S/Sxs of hypercalcemia (confusion, weakness, GI upset, constipation, N, V, and cardiac arrhythmias) give IV fluid for diuresis symptomatic and supportive Calcium Carbonate (TumS/ Alka Mints) [Antacid/ Calcium Supplement/Mineral/ Electrolyte] [OTC] Uses Hyperacidity associated w/ peptic ulcer Dz, hiatal hernia, etc Action Neutralizes gastric acid Dose 500 mg—2 g PO PRN -1- in renal impair Caution [C, ] Disp Chew tabs, susp SE t -1- PO constipation Interactions X Effect OF tetracyclines, fluo-... 

Rx prevent Ca deficiency Action Ca supl Dose Adul. 6—18 g/d doses Feds. 600-2000 mg/kg/d qid (9 d max) X in renal impair Caution [C, ] Contra T Ca Disp Syrup SE f O a, X PCO constipation. Interactions T Effects OF quinidine X effect OF tetracyclines X Ca absorption w/ high intake OF dietary fiber EMS Monitor ECG for signs of electrol5rte disturbances (T Ca % X Mg ) OD S/Sxs of hypercalcemia weakness, GI upset, and cardiac arrhythmias give IV fluid symptomatic and supportive... 

Common complaints are constipation and bloating, usually relieved by increasing dietary fiber or mixing psyllium seed with the resin. Resins should be avoided in patients with diverticulitis. Heartburn and diarrhea are occasionally reported. 

Prussian blue has not been associated with significant adverse effects. Constipation, which may occur in some cases, should be treated with laxatives or increased dietary fiber. 

Patients taking colestyramine often have constipation, abdominal discomfort, and heartburn, but dietary fiber, such as psyllium, can reduce the symptoms (5,6). Other effects are flatulence, nausea, and fecal impaction a mild laxative may be needed, particularly in the elderly. Many other patients complain of anorexia and occasionally there is diarrhea. Doses of colestyramine higher than the 10-16 g normally used can cause steatorrhea (7). 

Oxycodone s effects on the central nervous system produce pain relief, euphoria, and slowed breathing. It also decreases the activity of the intestinal tract, often leading to constipation. To combat this, patients are advised to drink six to eight full glasses of water per day and increase the amount of dietary fiber they eat. 

Jerusalem artichoke has beneficial effects on digestion. It is a good source of dietary fiber, for instance, which helps to bulk food and reduce constipation. However, there can be digestive downsides too. 

Dry mouth can be managed with increased intake of fluids, oral lubricants (Xerolube), ice chips, or use of sugarless chewing gum or hard candy. Constipation can be treated with increases in exercise, fluid, and dietary fiber intake. 

Dietary fiber is commonly used for the treatment of various maladies of the gastrointestinal tract, such as constipation, diverticular disease, irritable bowel... 

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