University of Minnesota School of Nursing, Minneapolis, MN 554565, USA.
Nurs Res. 2011 May-Jun;60(3 Suppl):S58-67. doi: 10.1097/NNR.0b013e3182186d8c.
Knowledge about adverse symptoms over time from fiber supplementation is lacking.
The aim of this study was to compare the severity of adverse gastrointestinal (GI) symptoms during supplementation with dietary fiber or placebo over time in adults with fecal incontinence. A secondary aim was to determine the relationship between symptom severity and emotional upset and their association with study attrition and reducing fiber dose.
Participants (N = 189; 77% female; 92% White; age, M = 58 years, SD = 14 years) with fecal incontinence were randomly assigned to a placebo or a supplement of 16 g total dietary fiber per day from 1 of 3 sources: gum arabic, psyllium, or carboxymethylcellulose. They reported GI symptoms daily during baseline (14 days), incremental fiber dosing (6 days), and 2 segments of steady full fiber dose (32 days total).
Severity of symptoms in all groups was minimal. Adjusting for study segment and day, a greater feeling of fullness in the psyllium group was the only symptom that differed from symptoms in the placebo group. The odds of having greater severity of flatus, belching, fullness, and bloating were 1.2-2.0 times greater in the steady dose segment compared with baseline. There was a positive association between symptom severity and emotional upset. Participants with a greater feeling of fullness or bloating or higher scores for total symptom severity or emotional upset were more likely to withdraw from the study sooner or reduce fiber dose.
Persons with fecal incontinence experience a variety of GI symptoms over time. Symptom severity and emotional upset appear to influence fiber tolerance and study attrition. Supplements seemed well tolerated.
关于纤维补充剂随时间推移产生不良反应症状的知识还很缺乏。
本研究旨在比较成人粪便失禁患者在补充膳食纤维或安慰剂期间随时间推移时胃肠道（GI）不良反应症状的严重程度。次要目的是确定症状严重程度与情绪困扰之间的关系，并确定其与研究脱落和减少纤维剂量的关系。
参与者（N=189；77%为女性；92%为白人；年龄，M=58 岁，SD=14 岁）患有粪便失禁，被随机分配到安慰剂组或每天补充 16 克总膳食纤维，来自 3 种来源之一：阿拉伯胶、车前子壳或羧甲基纤维素。他们在基线（14 天）、增量纤维剂量（6 天）和 2 个稳定全纤维剂量阶段（总计 32 天）期间每天报告 GI 症状。
所有组的症状严重程度都很小。调整研究阶段和天数后，车前子壳组的饱腹感比安慰剂组更强烈，这是唯一与安慰剂组不同的症状。与基线相比，稳定剂量阶段出现更多的排气、打嗝、饱腹感和腹胀的可能性是 1.2-2.0 倍。症状严重程度与情绪困扰之间存在正相关。有更强烈的饱腹感或腹胀感，或总症状严重程度或情绪困扰评分较高的参与者更有可能提前退出研究或减少纤维剂量。
粪便失禁患者随时间推移会经历各种胃肠道症状。症状严重程度和情绪困扰似乎会影响纤维耐受性和研究脱落。补充剂似乎耐受性良好。
