What is the role of fiber in the treatment of constipation?

Fiber has long been used in the treatment of constipation. Dietary fiber, particularly water-insoluble fibers such as cellulose, increases stool weight due to its water-holding property. The transit time taken for the passage of material from the mouth to the anus is greatly reduced with a high-fiber diet.

People who consume a high-fiber diet (100 to 170 grams per day) usually have a transit time of thirty hours and a fecal weight of 500 grams.In contrast, Europeans and Americans, who typically eat a low-fiber diet (20 grams per day) have a transit time of greater than forty-eight hours and a fecal weight of only 100 grams. The increased intestinal transit time associated with a Western diet allows prolonged exposure to various cancer-causing compounds within the intestines. Fiber should be considered not only for the treatment of constipation but also the treatment of diarrhea due to irritable bowel syndrome.

When fiber is added to the diet of subjects with an abnormally rapid transit time of less than twenty-four hours, it slows down the transit time. Dietary fiber acts to normalize bowel movements. The effect of dietary fiber on the transit time is apparently directly related to its effect on the stool weight and size.

A larger, bulkier stool passes through the colon more easily; it requires less pressure to be produced during defecation and subsequently less straining. This reduces stress on the colon wall and therefore avoids the ballooning effect that creates diverticuli, which are sacs or pouches in the wall of the intestinal tract. Diverticuli can become lodged with feces, causing inflammation, which is called diverticulitis.

Dietary fiber also prevents the formation of hemorrhoids and varicose veins.

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