Dahl Wendy J, Mendoza Daniela Rivero
a Food Science and Human Nutrition Department, University of Florida, Gainesville, FL.
Can J Diet Pract Res. 2018 Mar 1;79(1):35-41. doi: 10.3148/cjdpr-2017-028. Epub 2017 Oct 3.
The high prevalence of constipation in long-term care (LTC) residents has been a long-standing issue for caregivers, attending health professionals, and the residents themselves. The traditional medical response has been to utilize pharmaceutical laxatives, enemas, and suppositories for treatment. The purpose of this review was to determine if fibre supplementation (including fibre added to foods) is effective in increasing stool frequency, improving stool consistency, and decreasing laxative use in LTC residents. A systematic search was conducted using PubMed and CINAHL databases, inclusive to March 2017. Search terms included: "long-term care" or "nursing home" AND "fiber (fibre)," "bran," "psyllium," "inulin," or "prebiotic." Intervention trials of fibre supplementation with ≥5 LTC residents were included. The search generated 456 articles following removal of duplicates; 8 studies met the inclusion criteria. Three additional trials were identified through a hand search of references of pertinent articles. Current evidence suggests that added fibre may be effective in increasing stool frequency and/or decreasing laxative use in LTC residents and, thus, may lessen the burden of constipation. However, randomized controlled trials are needed to clearly demonstrate the effects of adding fibre to foods, particularly insoluble and less fermentable sources, on constipation in LTC residents.
长期护理（LTC）机构居民中便秘的高发生率，一直是护理人员、主治医疗专业人员以及居民自身长期面临的问题。传统的医学应对方法是使用药物性泻药、灌肠剂和栓剂进行治疗。本综述的目的是确定补充膳食纤维（包括添加到食物中的纤维）是否能有效增加长期护理机构居民的排便次数、改善粪便稠度并减少泻药的使用。使用PubMed和CINAHL数据库进行了系统检索，检索截至2017年3月。检索词包括：“长期护理”或“疗养院”以及“纤维”、“麸皮”、“车前草”、“菊粉”或“益生元”。纳入了≥5名长期护理机构居民的膳食纤维补充干预试验。去除重复项后，检索共产生456篇文章；8项研究符合纳入标准。通过手工检索相关文章的参考文献又确定了3项试验。目前的证据表明，添加纤维可能有效增加长期护理机构居民的排便次数和/或减少泻药的使用，因此可能减轻便秘负担。然而，需要进行随机对照试验来明确证明在食物中添加纤维，特别是不溶性和发酵性较低的纤维来源，对长期护理机构居民便秘的影响。
