II. Indications
III. Physiology
- Dietary Fiber improves stool bulk and transit time
- Dietary Fiber lowers serum Cholesterol
IV. Precaution
- Fiber content listed below is approximate
- Various texts list different fiber per serving
V. Adverse Effects
- Use with 64 oz/day (>1.8 Liters/day) non-caffeinated fluid
- Poorly tolerated in atonic colon (e.g. Megacolon)
- Gas (bloating, Abdominal Distention, Flatulence)
- More common if started too quickly with high dosing
- Reduced by gradually increasing fiber intake to 225-30 grams per day
- Side effects more likely with dyssynergic Defecation
- Side effects are more common with insoluble fiber
- Insoluble fiber examples include (Methylcellulose, Citrucel, wheat bran)
- In contrast, soluble fiber (psyillium, Metamucil, oat bran) is associated with less gas
VI. Drug Interactions
- May interfere with absorption of medications
- Do not take medications at the same time as Psyllium
- Space Psyllium several hours apart from medications
- Agents known to be affected
VII. Preparations: Dietary Fiber Sources
- Whole grain cereals or breads
- All-Bran or 100% Bran Cereal (>8 grams per serving)
- Wheaties (2.6 grams per serving)
- Shredded Wheat (6 grams per serving)
- Grits (5 grams per serving)
- Grape-nuts (5 grams per serving)
- Fresh fruits
- Raspberries (4.5 grams per serving)
- Fruits with 1-3 grams fiber per serving
- Apple with peal
- Orange
- Peach
- Pear
- Strawberries
- Fruits with negligible fiber
- Grape-fruit has only 0.6 grams fiber per serving
- Apple juice has no fiber content
- Vegetables (raw better than cooked)
- Beans (>8 grams per serving)
- Kidney beans
- Lima beans
- Navy beans
- Baked beans
- Peas (6 grams per serving)
- Corn on the cob (6 grams per serving)
- Parsnips (6 grams per serving)
- Lentils (4 grams per serving)
- Broccoli (3 grams per serving)
- Baked Potato with skin (3 grams per serving)
- Other vegetables with 1-2 grams fiber per serving
- Beets
- Cabbage
- Carrots
- Celery
- Corn
- Squash
- Green beans
- Turnips
- Beans (>8 grams per serving)
- Other sources
- Whole wheat bread (1.3 grams per serving)
VIII. Bulk-Forming agents
- Psyllium (Metamucil): 10 grams per day
- Dose: 1-2 tsp in 8 ounces of water or juice PO tid
- Methylcellulose (Citrucel): 6 grams per day
- Dose: 2 grams in 8 ounces liquid PO tid
- Calcium Polycarbophil (Fibercon)
- Dose: Two 625 mg tablets PO tid
- Synthetic bulk agent containing polyacrylic acid
- Dietary sources with as much fiber at 10% of cost
- Wheat bran, oat bran or all-bran cereal
- Lima, Navy, Kidney and baked beans
IX. References
- Brody (1981) Nutrition Book, p. 147
- Cheskin in Barker (1995) Ambulatory Medicine, p. 479
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Related Studies
| fiber (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| FIBER TABLET | Generic OTC | $0.06 each |
| FIBER TABS | Generic OTC | $0.06 each |
| FIBER THERAPY 500 MG CAPLET | Generic OTC | $0.06 each |
| FIBER THERAPY POWDER | Generic OTC | $0.01 per gram |
| FIBER-LAX CAPTABS | Generic OTC | $0.06 each |