Long-term fiber intake may help preserve bowel control

(Reuters Health) - Women who include a lot of fiber in their diets may have a lower risk for problems with bowel control as they age, a study suggests.

The inability to control bowel movements, or bowel leakage - known as fecal incontinence - affects roughly 1 in 6 noninstitutionalized elderly Americans, according to the U.S. Centers for Disease Control and Prevention.

“It is quietly debilitating because of the stigma around the condition,” study leader Dr. Kyle Staller of Harvard Medical School in Boston told Reuters Health by email. “Once affected, patients have few treatment options.”

Staller and colleagues examined the association between long-term dietary fiber intake and fecal incontinence risk among more than 58,000 older women in the Nurses’ Health Study. All of the women had filled out food frequency questionnaires at regular intervals between 1984 and 2006. As of 2008, none of them were incontinent.

By 2012, more than 7,000 were experiencing more than one fecal incontinence episode per month.

When the researchers divided the women into five groups based on their fiber intake over time, women with the highest intake - about 25 grams per day, on average - had a fecal incontinence risk that was 18 percent lower than the risk for women in the group with the lowest fiber intake.

Women with the highest intake of fiber also had a 31 percent lower risk of diarrhea.

Whole grains and vegetables were the largest sources of dietary fiber.

The study can’t prove that a specific amount of fiber intake will prevent fecal incontinence. Still, the results are in alignment with U.S. Department of Health and Human Services recommendation of 25 grams of dietary fiber per day.

The prevalence of fecal incontinence is expected to increase about 60 percent in older U.S. women by 2050, the researchers say.

“Many people do not know how prevalent it is and feel as if they are the only ones with the problem,” said Donna Bliss of the University of Minnesota School of Nursing in Minneapolis, who wasn’t involved with this study.

In an earlier study, Bliss and her colleagues found that a type of fiber called psyllium was more effective than other fiber supplements (such as gum arabic and carboxymethylcellulose) at improving fecal incontinence.

“There is the idea among some people that fecal incontinence is an inevitable consequence of aging,” Bliss told Reuters Health by email. “These findings suggest a way that people might prevent fecal incontinence and feel more of a sense of control over their health.”

SOURCE: Gastroenterology, online May 11, 2018.