Dietary Fiber for Fecal Incontinence

The Impact of Fiber Fermentation on Fecal Incontinence

The primary aim of this study was to compare the effects of supplementation with one of three dietary fibers (gum arabic, carboxy-methylcellulose, or psyllium) or a placebo on fecal incontinence (FI), symptom intolerance, and quality of life in community-living individuals who have incontinence of loose or liquid feces. A secondary aim was to explore the possible mechanism(s) underlying the supplements' efficacy (i.e., improvements in stool consistency, water-holding capacity or gel formation).

Inclusion Criteria:

• age ≥18 years
• living in the community (not a nursing home or assisted living facility)
• self-report of usually having FI of loose or liquid consistency at least twice in a 2-wk period
• toilets independently
• ability to read and write in English.
• Persons that regularly performed pelvic floor muscle exercises and/or biofeedback on a maintenance regimen for at least 20 wks or who took a steady dose of anti-motility medications on a regular schedule that still met the FI criteria were also eligible.

Exclusion Criteria:

• difficulty swallowing,
• a gastrointestinal (GI) tract altered by surgery,
• a malabsorption disorder,
• inflammatory bowel disease,
• gastrointestinal cancer or active cancer treatment,
• allergy to the fibers,
• regularly used a laxative or enema, were tube-fed, or unwilling to discontinue taking periodic self-prescribed fiber supplements or anti-diarrheal medications.
• a score ≤24 on the Mini Mental State Examination
• having/reporting fewer than two episodes of FI or being incapable of performing study procedures during the run-in baseline period