How is patient noncompliance with fiber supplement regimens addressed in the treatment of constipation?

Updated: Jul 05, 2019
  • Author: Marc D Basson, MD, PhD, MBA, FACS; Chief Editor: BS Anand, MD  more...
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Answer

To prevent patient noncompliance resulting from the cramping and bloating that may accompany changes in dietary fiber, fiber supplementation should be started at a low subtherapeutic dose and titrated upwards on a weekly basis until the desired effect is achieved. Patients should continue to increase the dose on a weekly basis until they experience daily bowel movements with no straining or until they reach the maximum dose.

Patients should be cautioned that these products are not laxatives, will not induce a bowel movement, and must be taken daily regardless of their perceived need.

Patients may increase or decrease their dose on a week-to-week basis. In particular, the author advises patients who have arrived at what they believe to be an appropriate and successful dose to increase the dose one additional step for at least a week and then back down if they wish. Some patients find that they actually prefer the higher dose. To ensure long-term compliance, the author believes that patients should titrate the doses in case of changes in potency between fiber supplement brands or changes in diet, fluid intake, or exercise.


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