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Effect of dietary fiber on constipation: a meta analysis.
World J Gastroenterol. 2012 Dec 28; 18(48):7378-83.WJ

Abstract

AIM

To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials (RCTs).

METHODS

We searched Ovid MEDLINE (from 1946 to October 2011), Cochrane Library (2011), PubMed for articles on dietary fiber intake and constipation using the terms: constipation, fiber, cellulose, plant extracts, cereals, bran, psyllium, or plantago. References of important articles were searched manually for relevant studies. Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency, stool consistency, treatment success, laxative use and gastrointestinal symptoms. The data were extracted independently by two researchers (Yang J and Wang HP) according to the described selection criteria. Review manager version 5 software was used for analysis and test. Weighted mean difference with 95%CI was used for quantitative data, odds ratio (OR) with 95%CI was used for dichotomous data. Both I(2) statistic with a cut-off of ≥ 50% and the χ(2) test with a P value < 0.10 were used to define a significant degree of heterogeneity.

RESULTS

We searched 1322 potential relevant articles, 19 of which were retrieved for further assessment, 14 studies were excluded for various reasons, five studies were included in the analysis. Dietary fiber showed significant advantage over placebo in stool frequency (OR = 1.19; 95%CI: 0.58-1.80, P < 0.05). There was no significant difference in stool consistency, treatment success, laxative use and painful defecation between the two groups. Stool frequency were reported by five RCTs, all results showed either a trend or a significant difference in favor of the treatment group, number of stools per week increased in treatment group than in placebo group (OR = 1.19; 95%CI: 0.58-1.80, P < 0.05), with no significant heterogeneity among studies (I(2)= 0, P = 0.77). Four studies evaluated stool consistency, one of them presented outcome in terms of percentage of hard stool, which was different from others, so we included the other three studies for analysis. Two studies reported treatment success. There was significant heterogeneity between the studies (P < 0.1, I(2) > 50%). Three studies reported laxative use, quantitative data was shown in one study, and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use (OR = 1.07; 95%CI 0.51-2.25), and no heterogeneity was found (P = 0.84, I(2)= 0). Three studies evaluated painful defecation: one study presented both quantitative and dichotomous data, the other two studies reported quantitative and dichotomous data separately. We used dichotomous data for analysis.

CONCLUSION

Dietary fiber intake can obviously increase stool frequency in patients with constipation. It does not obviously improve stool consistency, treatment success, laxative use and painful defecation.

Authors+Show Affiliations

Department of Clinical Nutrition, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

23326148

Citation

Yang, Jing, et al. "Effect of Dietary Fiber On Constipation: a Meta Analysis." World Journal of Gastroenterology, vol. 18, no. 48, 2012, pp. 7378-83.
Yang J, Wang HP, Zhou L, et al. Effect of dietary fiber on constipation: a meta analysis. World J Gastroenterol. 2012;18(48):7378-83.
Yang, J., Wang, H. P., Zhou, L., & Xu, C. F. (2012). Effect of dietary fiber on constipation: a meta analysis. World Journal of Gastroenterology, 18(48), 7378-83. https://doi.org/10.3748/wjg.v18.i48.7378
Yang J, et al. Effect of Dietary Fiber On Constipation: a Meta Analysis. World J Gastroenterol. 2012 Dec 28;18(48):7378-83. PubMed PMID: 23326148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of dietary fiber on constipation: a meta analysis. AU - Yang,Jing, AU - Wang,Hai-Peng, AU - Zhou,Li, AU - Xu,Chun-Fang, PY - 2012/08/12/received PY - 2012/10/01/revised PY - 2012/11/11/accepted PY - 2013/1/18/entrez PY - 2013/1/18/pubmed PY - 2014/1/10/medline KW - Constipation KW - Dietary fiber KW - Meta-analysis KW - Stool consistency KW - Stool frequency SP - 7378 EP - 83 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 18 IS - 48 N2 - AIM: To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials (RCTs). METHODS: We searched Ovid MEDLINE (from 1946 to October 2011), Cochrane Library (2011), PubMed for articles on dietary fiber intake and constipation using the terms: constipation, fiber, cellulose, plant extracts, cereals, bran, psyllium, or plantago. References of important articles were searched manually for relevant studies. Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency, stool consistency, treatment success, laxative use and gastrointestinal symptoms. The data were extracted independently by two researchers (Yang J and Wang HP) according to the described selection criteria. Review manager version 5 software was used for analysis and test. Weighted mean difference with 95%CI was used for quantitative data, odds ratio (OR) with 95%CI was used for dichotomous data. Both I(2) statistic with a cut-off of ≥ 50% and the χ(2) test with a P value < 0.10 were used to define a significant degree of heterogeneity. RESULTS: We searched 1322 potential relevant articles, 19 of which were retrieved for further assessment, 14 studies were excluded for various reasons, five studies were included in the analysis. Dietary fiber showed significant advantage over placebo in stool frequency (OR = 1.19; 95%CI: 0.58-1.80, P < 0.05). There was no significant difference in stool consistency, treatment success, laxative use and painful defecation between the two groups. Stool frequency were reported by five RCTs, all results showed either a trend or a significant difference in favor of the treatment group, number of stools per week increased in treatment group than in placebo group (OR = 1.19; 95%CI: 0.58-1.80, P < 0.05), with no significant heterogeneity among studies (I(2)= 0, P = 0.77). Four studies evaluated stool consistency, one of them presented outcome in terms of percentage of hard stool, which was different from others, so we included the other three studies for analysis. Two studies reported treatment success. There was significant heterogeneity between the studies (P < 0.1, I(2) > 50%). Three studies reported laxative use, quantitative data was shown in one study, and the pooled analysis of the other two studies showed no significant difference between treatment and placebo groups in laxative use (OR = 1.07; 95%CI 0.51-2.25), and no heterogeneity was found (P = 0.84, I(2)= 0). Three studies evaluated painful defecation: one study presented both quantitative and dichotomous data, the other two studies reported quantitative and dichotomous data separately. We used dichotomous data for analysis. CONCLUSION: Dietary fiber intake can obviously increase stool frequency in patients with constipation. It does not obviously improve stool consistency, treatment success, laxative use and painful defecation. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/23326148/Effect_of_dietary_fiber_on_constipation:_a_meta_analysis_ L2 - https://www.wjgnet.com/1007-9327/full/v18/i48/7378.htm DB - PRIME DP - Unbound Medicine ER -