Fiber aids constipation in pelvic floor disorders

Gradually building up to a high-fiber diet may ease constipation in women with problems known as pelvic floor disorders, a small study shows.

Researchers found that among 41 women with pelvic floor disorders, those who were able to bulk up the fiber in their diets saw an improvement in constipation after six weeks.

Pelvic floor disorders refer to problems with a woman's pelvic organs - the uterus, bladder and rectum - and the muscles and connective tissue that support them. Among the most common of these are incontinence and pelvic organ prolapse, where weakened muscles and supporting tissue allow one or more pelvic organs to drop down and protrude into the vagina.

It's been estimated that one-third of U.S. women have at least one type of pelvic floor disorder, many of whom have chronic constipation.

For the current study, described in the medical journal Obstetrics & Gynecology, Dr. Amir Shariati and colleagues at Indiana University in Indianapolis looked at whether a high-fiber cereal could help.

They recruited 41 women, ages 33 to 77, who came to the researchers' center for a pelvic floor disorder. Eighteen women had a primary problem of pelvic organ prolapse, while the rest had conditions such as incontinence and overactive bladder. All had had chronic constipation for at least three out of the past 12 months.

Over the six-week study, the women added a high-fiber cereal to their diets, gradually increasing their daily serving until they reached a fiber intake of 28 grams per day.

Experts recommend that women older than 50 get 20 to 25 grams of fiber per day, but the typical U.S. diet includes far less.

At the end of the study, the women generally reported improvements in their constipation and symptoms such as abdominal pain and bloating. Their average laxative use declined from three times per week to about once a week, the researchers note.

On the downside, six women had to drop out of the study because the added fiber caused intolerable symptoms like gas and stomach pain. The researchers stress that it's important for women to gradually add fiber to their diets to reduce the odds of such side effects.

Constipation and straining is thought to worsen, or possibly contribute to, pelvic organ prolapse. The current findings, Shariati's team writes, suggest that a high-fiber diet could help prevent pelvic organ prolapse or keep it from progressing.

Larger clinical trials are needed to investigate this question, they conclude.

SOURCE: Obstetrics & Gynecology, April 2008.