Abstract
Fifty-eight patients with uncomplicated diverticular disease of the colon took bran crispbread, ispaghula drink, and placebo for four months each in a randomised, cross-over, double-blind controlled trial. Assessments were made subjectively, using a monthly self-administered questionnaire, and objectively, by examining a seven-day stool collection at the end of each treatment period. In terms of a pain score, lower bowel symptom score (the pain score and sensation of incomplete emptying, straining, stool consistency, flatus, and aperients taken), and total symptom score (belching, nausea, vomiting, dyspepsia, and abdominal distension) fibre supplementation conferred no benefit. Symptoms of constipation, however, when assessed alone, were significantly relieved. Both fibre regimens produced the expected changes in stool weight, consistency, and frequency. It is concluded that dietary fibre supplements in the commonly used doses do no more than relieve constipation. Perhaps the impression that fibre helps diverticular disease is simply a manifestation of Western civilisation's obsession with the need for regular frequent defecation.
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- Baird I., Littlewood E. R., Ornstein M. Simple method for faecal collection. Lancet. 1978 Apr 1;1(8066):725–725. doi: 10.1016/s0140-6736(78)90849-8. [DOI] [PubMed] [Google Scholar]
- Brodribb A. J., Humphreys D. M. Diverticular disease: threee studies. Part II - Treatment with bran. Br Med J. 1976 Feb 21;1(6007):425–428. doi: 10.1136/bmj.1.6007.425. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brodribb A. J. Treatment of symptomatic diverticular disease with a high-fibre diet. Lancet. 1977 Mar 26;1(8013):664–666. doi: 10.1016/s0140-6736(77)92112-2. [DOI] [PubMed] [Google Scholar]
- Connell A. M. Natural fiber and bowel dysfunction. Am J Clin Nutr. 1976 Dec;29(12):1427–1431. doi: 10.1093/ajcn/29.12.1427. [DOI] [PubMed] [Google Scholar]
- Cummings J. H., Branch W., Jenkins D. J., Southgate D. A., Houston H., James W. P. Colonic response to dietary fibre from carrot, cabbage, apple, bran. Lancet. 1978 Jan 7;1(8054):5–9. doi: 10.1016/s0140-6736(78)90357-4. [DOI] [PubMed] [Google Scholar]
- Cummings J. H., Hill M. J., Jenkins D. J., Pearson J. R., Wiggins H. S. Changes in fecal composition and colonic function due to cereal fiber. Am J Clin Nutr. 1976 Dec;29(12):1468–1473. doi: 10.1093/ajcn/29.12.1468. [DOI] [PubMed] [Google Scholar]
- Cummings J. H., Jenkins D. J., Wiggins H. S. Measurement of the mean transit time of dietary residue through the human gut. Gut. 1976 Mar;17(3):210–218. doi: 10.1136/gut.17.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eastwood M. A., Kirkpatrick J. R., Mitchell W. D., Bone A., Hamilton T. Effects of dietary supplements of wheat bran and cellulose on faeces and bowel function. Br Med J. 1973 Nov 17;4(5889):392–394. doi: 10.1136/bmj.4.5889.392. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans D. M., Craven J. L., Murphy F., Cleary B. K. Comparison of "early gastric cancer" in Britain and Japan. Gut. 1978 Jan;19(1):1–9. doi: 10.1136/gut.19.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hodgson W. J. The placebo effect. Is it important in diverticular disease? Am J Gastroenterol. 1977 Feb;67(2):157–162. [PubMed] [Google Scholar]
- Painter N. S., Almeida A. Z., Colebourne K. W. Unprocessed bran in treatment of diverticular disease of the colon. Br Med J. 1972 Apr 15;2(5806):137–140. doi: 10.1136/bmj.2.5806.137. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Painter N. S., Burkitt D. P. Diverticular disease of the colon: a deficiency disease of Western civilization. Br Med J. 1971 May 22;2(5759):450–454. doi: 10.1136/bmj.2.5759.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Plumley P. F., Francis B. Dietary management of diverticular disease. J Am Diet Assoc. 1973 Nov;63(5):527–530. [PubMed] [Google Scholar]
- Srivastava G. S., Smith A. N., Painter N. S. Sterculia bulk-forming agent with smooth-muscle relaxant versus bran in diverticular disease. Br Med J. 1976 Feb 7;1(6005):315–318. doi: 10.1136/bmj.1.6005.315. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Taylor I., Duthie H. L. Bran tablets and diverticular disease. Br Med J. 1976 Apr 24;1(6016):988–990. doi: 10.1136/bmj.1.6016.988. [DOI] [PMC free article] [PubMed] [Google Scholar]