Fiber can be defined as coarse, indigestible plant matter, consisting primarily of polysaccharides such as cellulose. Fruits high in fiber content are: artichokes, apples, pears, berries, dates, and figs. Vegetables that are highest per serving are: beans, broccoli, chick peas, lentils, pumpkin, and squash. Note that lettuce, tomatoes and cucumbers are not in the highest per serving category. While the typical garden salad contains some quantity of fiber, a diet with two salads a day is not enough for your daily needs. Fiber is not exclusively found in fruit and vegetables. It also is present in cereals, whole wheat bread, barley, and sunflower seeds to name a few other sources.
Fiber has been utilized by physicians to help regulate the passage of stool, especially in constipated individuals. Fiber is indigestible and therefore travels through the digestive tract to the colon. Once in the colon it adds bulk to the stool and hence propels the stool and promotes a bowel movement with less straining and effort. Of note, fiber may also aid patients suffering from chronic diarrhea. The mechanism appears to be its absorption of excess water in the lumen of the colon. In these patients, smaller doses of fiber are required.
Due to the positive effects on both constipation and diarrhea, fiber has been used by many as the first line for treating
Often at the initiation of fiber therapy, especially in patients with Irritable Bowel Syndrome (IBS). There are different subsets of IBS: constipation predominant, diarrhea predominant, intermittent constipation/diarrhea, and only pain. While fiber may be an option in all of these entities, it is of particular utilized foremost for the intermittent patients. This subset of patient can sometimes fall into the trap of self administering laxatives for their constipation only to subsequently experience a severe case of diarrhea. At this point they will take an anti-diarrhea medication and the cycle starts over again. Obviously this should be avoided. Fiber therapy often will prevent or at least minimize these severe swings of irregularity.
Often at the initiation of fiber therapy, especially in patients with IBS, an increase of gas and bloating will be noted. However, the colon adapts to this and gas minimizes over a few weeks. It is often recommended to start at a lower dose of fiber supplementation at first and then increase every week.
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