Rome Foundation Working Group | Published:

Fiber and Functional Gastrointestinal Disorders

The American Journal of Gastroenterology volume 108, pages 718727 (2013) | Download Citation

Abstract

Despite years of advising patients to alter their dietary and supplementary fiber intake, the evidence surrounding the use of fiber for functional bowel disease is limited. This paper outlines the organization of fiber types and highlights the importance of assessing the fermentation characteristics of each fiber type when choosing a suitable strategy for patients. Fiber undergoes partial or total fermentation in the distal small bowel and colon leading to the production of short-chain fatty acids and gas, thereby affecting gastrointestinal function and sensation. When fiber is recommended for functional bowel disease, use of a soluble supplement such as ispaghula/psyllium is best supported by the available evidence. Even when used judiciously, fiber can exacerbate abdominal distension, flatulence, constipation, and diarrhea.

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Acknowledgements

The authors would specifically like to thank Dr John McRorie for his contributions and edits to the “Fiber metabolism” section of the manuscript.

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Affiliations

  1. Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA

    • Shanti Eswaran
    •  & William D Chey
  2. Monash University, Melbourne, Victoria, Australia

    • Jane Muir

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Competing interests

Guarantor of the article: William D. Chey, MD, AGAF, FACG, FACP.

Specific author contributions: Dr Eswaran drafted the manuscript and prepared the tables. Dr Muir contributed to the writing, referencing, and preparation of the manuscript and tables. Dr Chey proofed and finalized the text. All authors approved the final draft submitted.

Financial support: None.

Potential competing interests: Dr Eswaran and Jane Muir have no potential competing interests. William D. Chey is a consultant for Nestlé/Prometheus.

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Correspondence to William D Chey.

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https://doi.org/10.1038/ajg.2013.63

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