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Obstetrics & Gynecology 2008;111:908-913
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

High-Fiber Diet for Treatment of Constipation in Women With Pelvic Floor Disorders

Amir Shariati, MD1, Jose S. Maceda, MD1 and Douglass S. Hale, MD1

From the 1Department of Female Pelvic Medicine and Reconstructive Surgery, Indiana University/Methodist Hospital, Indianapolis, IN.

OBJECTIVE: To examine the effect of high-fiber diet on constipation in women with pelvic floor disorders.

METHODS: This was a study of a prospective cohort of 41 consecutive women presenting to a tertiary care facility for pelvic floor disorders with a complaint of constipation from March 2005 to September of 2005. Patient Assessment of Constipation Symptoms and Rome II criteria administered as a questionnaire were obtained through telephone interviews every 14 days and were evaluated at the end of the 42-day study period. Each patient was instructed to supplement her diet with a high-fiber cereal (14 g of fiber per one-half cup). Women gradually increased their cereal intake with a goal of reaching 28 g of fiber daily. Patients with adverse reactions, abdominal bloating or pain, and surgery during the study period were withdrawn.

RESULTS: Median age and body mass index were 60 years (range 33–77 years), and 29.9 kg/m2 (range 21.6–59.8), respectively. Thirty patients (73%) completed the study. Average Rome II scores improved from day 1 to day 42 (P<.05). The total, abdominal, rectal, and stool symptoms of the Patient Assessment of Constipation Symptoms improved significantly during the study period (P<.001). Weekly laxative use and vaginal splinting were decreased from 2.8, 1.5 to 1.4, 0.67 (P<.05), respectively.

CONCLUSION: Increasing fiber intake gradually to the amount recommended by the National Academy of Sciences Institute of Medicine improves constipation and its associated symptoms. Reducing the incidence and severity of straining in constipated women may help a risk factor for the onset, progression, or recurrence of prolapse.

LEVEL OF EVIDENCE: III






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