Original article
Cutoff Volume of Dietary Fiber to Ameliorate Constipation in Children

https://doi.org/10.1016/j.jpeds.2007.12.044Get rights and content

Objective

To evaluate the proper ingested volume of dietary fiber for relieving constipation in children.

Study design

During a 3-year period, we prospectively evaluated the correlation of intake volume of dietary fiber with improvement of constipation in children. Patients were categorized into younger (3-7 years) and older (8-14 years) children. The evaluation period lasted 12 weeks. A good improvement was defined as the child exhibiting at least 60% relief of the constipation symptoms during the observation period. Freedom from constipation was observed during the last 4 weeks.

Results

The study population consisted of 422 patients (213 younger, 209 older), with a mean age of 7.89 ± 4.71 years. Baseline daily dietary fiber intake of the younger and older groups was 5.97 ± 2.35 g and 9.83 ± 3.51 g, respectively. 227 cases (53.8 %) showed improvement of constipation, and 49.1 % of the patients had relief of constipation. Greater intake of dietary fiber was positively associated with good improvement of constipation in both groups (P = .002, and P < .001). Cutoff volumes of daily dietary fiber intake in the relief of constipation were 10 g in the younger group and 14.5 g in the older group.

Conclusion

The cutoff of dietary fiber intake needed to relieve constipation increased with age, achievable in a 12-week intervention.

Section snippets

Patients

During a 3-year period (January 2003-January 2006), we conducted a prospective dietary program to determine the adequate intake of dietary fiber to relieve constipation in children diagnosed at the pediatric gastroenterology clinic. Subjects were between 4 and 14 years of age and sustained at least 2 weeks of defecating <3 times per week. To evaluate the proper volumes of intake of dietary fiber for the relief of constipation in patients of different age groups, patients were categorized into a

Demographic and Clinical Features

540 patients were recruited for the study; 57 children with acute illness (30 upper respiratory tract infection, 27 gastroenteritis), 32 cases with incomplete dietary recording, and 29 cases with poor compliance of follow-up visits were withdrawn from the study, giving a total of 422 patients participating (234 male and 188 female). The mean age of the 422 patients was 7.89 ± 3.71 years (range, 3.1-14.9 years). The younger group consisted of 219 children (51.9 %) with a mean age of 5.77 ± 1.59

Discussion

Several factors have been associated with constipation, such as the vicious cycle of a painful bowel movement followed by withholding of stools, genetic factors, disturbances of intestinal motility, and dietary habits.13, 14, 15 In this study, the mean duration of constipation in the patients was relatively shorter than that of the patients observed in some earlier reports, and this may be because in our study we emphasized an early dietary intervention. The results of this study found a strong

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