FECAL CONSISTENCY AS A MARKER OF GOOD RESPONSE IN THE TREATMENT OF INTESTINAL FUNCTIONAL DISORDERS AND THE ROLE OF SOLUBLE FIBERS

Introduction Intestinal functional disorders are among the most frequent gastrointestinal disorders. Soluble dietary fibers are included in some constipation and fecal incontinence guidelines. A simple way to assess normal intestinal transit is through fecal consistency, commonly demonstrated by the Bristol Stool Scale (BSS). Individuals with normal stools (BSS 3 and 4) tend to have a lower incidence of gastrointestinal symptoms.

Objective To evaluate the clinical response to the use of partially hydrolyzed guar gum soluble fibers and inulin, according to fecal consistency, as the first approach in the treatment of intestinal functional disorders.

Methods Prospective study of 742 patients with functional bowel disorders taking one measuring spoon (5g) of partially hydrolyzed guar gum (60%) and inulin (40%) added to water two times a day for 30 days. If BSS was 1 to 2, patients were told to mix the measuring spoon to 250 - 300 mL of water. If BSS was 5 to 7, to 50 - 100 mL, and if BSS was 3 to 4, to 200 mL. Mean BSS, global improvement percentage, complication rate, Constipation Scoring System (CSS) and Cleveland Clinic Incontinence Score (CCIS) were applied during the first appointment and during the 30-day follow-up appointment.

Results Of the 742 patients, 63.5% were female, with a mean age of 49.2 years. All patients informed no difficulty in complying with the soluble fiber protocol. Initial mean CSS was 13,0 (+-4,2) and CCIS was 2 (+-1). Mean BSS of constipation patients was 2 (+- 1) of functional diarrhea and fecal incontinence was 5 (+-1) and of irritable bowel syndrome was 5 (+-1), respectively. On the 30-day follow-up appointment, 73.5% of the patients had BSS types 3 and 4, associated with 65.9% (+- 15.7) of significant overall improvement. Mean CSS was 6 (+-3,9) and CCIS was 1 (+-1), p < 0,01. Patients who presented the other types of fecal consistency (26.5%), the significant overall improvement was only 20.2% (+-15.2). Mean CSS was 9 (+-1,5) and CCIS was 2 (+-1), p > 0,01.

Conclusion Achieving normal fecal consistency is associated with significant overall improvement. Oral soluble fibers use according to fecal consistency are a valid tool for treating bowel movement disorders.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025