Results with short-term and long-term fiber restricted diet in therapy-resistant constipation with severe pain

Background: The treatment of colonic inertia, when well documented and assuming failure of an aggressive and prolonged trial of laxatives, fiber, and prokinetics, is total colectomy with ileorectal anastomosis (Pemberton JH et al 1991). Surgical procedures are designed to treat difficult and infrequent evacuation and associating symptoms (e.g. abdominal pain and bloating) not necessarily being relieved by achieving regular defecation. Results with surgery of defecation abnormalities are relatively poor. Aim of this retrospective study was to investigate result of short-term (1 month) or long-term (6 month) very-low-fiber diet in patients with constipation resistant for conventional therapeutic trials. Results: 15 patients with severe constipation were studied and given short-term zero-fiber diet. Some of them (n=12) needed long-term low-fiber diet. Others (n=3) did not tolerate low fiber diet for more than 1 month. In the short-term 3 of the patients reported complete relief of pain, 6 of them had improvemet. 9 of 15 got normal frequency of stool. In the long term 1 of 15 patients reported complete relief of pain, 3 of them had improvemet. 8 of 15 got normal frequency of stool. Conclusions: Zero-fiber diet is not in the therapeutic protocol of severe constipation, but it seems to increase stool frequency on a short-term basis, similarly to long-term low-fiber diet, however fiber restriction was not effective in pain-relief.