Disability - fibre and constipation

Some people with disabilities suffer from constipation. Contributing factors can include the medications that they may take, low levels of physical activity, insufficient fluids and a diet that may be too low in fibre. Increasing the amount of fibre in the diet not only treats constipation but also lowers cholesterol, may reduce the risk of various cancers and bowel diseases, and improves general health and well-being

Two main types of fibre
The two broad categories of fibre include:

• Soluble fibre - softens the faeces by absorbing water and helps slow the rate of digestion and lower blood cholesterol and blood glucose. It is found in a range of foods including legumes, fruits, vegetables and oat bran

• Insoluble fibre - helps prevent constipation and other associated disorders, such as haemorrhoids, by adding bulk to the faeces and making the food products pass more quickly through the bowel. It is found in a range of foods including wheat bran and wholegrain cereals and breads.

Fibre keeps the digestive system healthy
Fibre:

• Encourages the passage of food and wastes through the digestive system (peristalsis).

• Reduces the risk of bowel diseases such as chronic constipation, diverticulitis and irritable bowel syndrome.

• May reduce the risk of various cancers, particularly those of the bowel.

Fluid is also important
Fibre can only help to relieve constipation if there is enough fluid in the diet for it to be able to do its work. Fibre absorbs water to produce a soft and bulky stool. Everyone should drink at least 2 litres of water each day, particularly in hot weather. Some people with a disability may need to be reminded to drink regularly. Water is the best drink.

Inactivity can cause constipation
Some people with a disability have conditions that affect their mobility, and this can also be a reason why a person is constipated. A person with a disability needs to be as active as possible each day, as every little bit of regular exercise helps.

Fibre can help with other health problems
A diet rich in fibre can help in many ways, including:

• Weight management - obesity increases the risk of a range of health problems, including diabetes and heart disease. Fibre is key to healthy weight management. Since it is indigestible, it provides a sensation of fullness without the kilojoules.

• Atherosclerosis - high blood cholesterol is a contributing factor in the development of atherosclerosis (narrowing of the arteries), which can cause a range of health problems including high blood pressure and heart disease. Soluble fibre (such as legumes, fruits and vegetables) helps to reduce blood cholesterol.

• Diabetes - a diet high in soluble fibre is digested and absorbed more slowly, which leads to lower blood glucose levels.

How much fibre?
Dietitians generally recommend about 30g of fibre every day. Packaged foods such as breads and cereals include nutrition information labels, which can help you to calculate your fibre intake, and nutrition books often include fibre charts. A dietitian can provide information to individuals on the type and quantities of foods that need to be eaten to achieve 30g of daily fibre in the diet each day. Examples of the fibre content in some foods include:

• Four slices of wholemeal bread - about 7g

• Half a cup of baked beans - about 7g

• Two medium pieces of fruit - about 6g.

General cautions
Changes to eating habits should be made with some care. For example:

• A sudden increase in dietary fibre can upset the digestive system and cause symptoms including flatulence (gas) and abdominal pain. It is better to slowly increase the amount of fibre in the diet over a period of several weeks.

• Diets that are too high in fibre can hinder the absorption of certain minerals including iron, zinc and calcium. Avoid consuming more than 35g of fibre per day.

• Do not use fibre supplements unless you have checked with your doctor or dietitian, since these products can aggravate or cause constipation, particularly if you don’t drink enough fluids. Some people with a disability have swallowing problems. Many fibre supplements thicken when added to fluid and this may cause a person with swallowing problems to choke.

• It is important to drink sufficient fluids. It may be helpful to always include a glass of water at each meal or snack.

Things to remember

• Some people with a disability suffer from constipation.

• Contributing factors can include medications, low levels of physical activity, insufficient fluids and a diet that is low in fibre.

• Dietitians generally recommend about 30g of fibre every day.