Why is a high fiber diet important?
Fiber, also called roughage or bulk, is necessary to promote the wavelike contractions that move food through the intestine. High fiber foods expand the inside walls of the colon, easing the passage of waste. As fiber passes through the intestine undigested, it absorbs many times its weight in water, resulting in softer and bulkier stools. Studies have shown that rural Africans, whose diets are rich in fiber, eliminate food waste in one third the time it takes urban, Westernized people to do so, and have larger and softer stools. Due to this greater bulk and faster transit time (the time required to digest food and expel wastes); it is believed that harmful substances are also swept out before they can cause problems. In fact, these rural people suffer less from many of the digestive tract diseases that plague Western man, and it is thought that this may be related to the nature of their diet.

A high-fiber diet causes a large, soft, bulky stool that passes through the bowel easily and quickly. Due to the elimination-easing action, some digestive tract disorders may be avoided, halted or even reversed. A softer, larger stool helps prevent constipation and straining, which can help avoid or relieve hemorrhoids. More bulk means less pressure in the colon, and this is important in treating irritable bowel syndrome and diverticulosis. Most Americans eat 10 to 15 grams of fiber a day, whereas 20 to 35 grams are recommended. High fiber foods, such as fruits and vegetables, also tend to be low in calories, so weight gain should not be a problem. Fiber pills generally should not be taken as they contain relatively little fiber and are expensive compared to fiber-containing foods and powder supplements.

What is fiber?
Dietary fiber is the undigested plant residue that passes through the intestinal tract. Just as there are many types of plants, there are also many types of fiber. Fiber may be soluble (oat bran, psyllium) and form a gelatinous bulk which has cholesterol-lowering properties. Or it may be insoluble (wheat and other grains) which adds bulk to the stool. Both are important and provide benefits.

What type of diet is best for people affected by Irritable Bowel Syndrome?
Irritable bowel syndrome, sometimes called spastic colon or IBS, is one of the most common disorders of the lower digestive tract. There is no disease process present in irritable bowel syndrome, but it can resemble other disorders: altered bowel habits (constipation, diarrhea or both alternately), abdominal pain, cramping and spasms. Acute episodes can be triggered by emotional tension and anxiety, poor dietary habits and certain medications. Increased amounts of fiber in the diet can help relieve symptoms of irritable bowel syndrome by producing soft, bulky stools and helping to normalize the time the stool takes to pass through the colon. The increased bulk also reduces the pressure necessary to push food wastes through the colon, resulting in less discomfort. If irritable bowel syndrome is not treated it may lead to diverticulosis of the colon.

Will a diet high in fiber prevent colon polyps/cancer?
Colon cancer is a major health problem. Countries in which grains are unprocessed and retain their fiber have a low incidence of colon cancer. Most colon cancer begins as a colon polyp, a benign mushroom-shaped growth which in time grows and, in some people, becomes a cancer. Colon cancer is curable if polyps are removed at an early stage. It is now known that heredity plays an important role in who develops colon cancer; however, there may be other factors involved as well. One theory is that cancer-causing chemicals (carcinogens) in the diet and environment remain in contact with the colon wall a longer time and in higher concentrations when the diet is low in fiber. However, a large, bulky stool acts to dilute and diffuse these carcinogens and to move them through the bowel more quickly. Less carcinogen exposure to the colon may mean less colon polyps and cancer.

What are high fiber foods?
High fiber foods can be found in most food groups. Different types of food should be selected to get the benefits of them all.

1. Legumes—The bean family excels in fiber, especially the soluble, cholesterol-lowering type. They include kidney, pinto, navy, lima and baked beans.
2. Whole Grains—Wheat bran and oat bran are present in a variety of cereals and breads. The label should say that the bread contains whole wheat or whole grain. Plain wheat bread may lack the fiber. One cannot always tell by the color. Some manufacturers artificially color bread brown to make it look more wholesome.
3. Whole Fresh Fruits—The valuable pectin fiber is found in the skin and pulp. Figs, prunes and raspberries have the highest fiber content.
4. Cooked or Stewed Fruits—Prunes and applesauce are good choices.
5. Green Leafy Vegetables—Lettuce, spinach, celery, and broccoli are good examples.
6. Root Vegetables-Potatoes, turnips and carrots are all excellent sources.

Since bran can cause rumbling intestinal gas and even some mild cramping, it should be ingested in small amounts initially. The amount can be increased as tolerance is acquired. The goal should be 20 to 35 grams of fiber a day, which will usually produce 1 to 2 soft, formed stools a day.

The following are good general rules:

1. Drink plenty of liquids, including fruit or vegetable juices and water.
2. Eat slowly and chew food thoroughly to allow the organs of the upper digestive tract (the esophagus, stomach and small intestine) to perform their jobs well. This may help prevent problems from developing in the lower digestive tract.
3. Eat meals at regular intervals.

Can I take a supplement to help increase my fiber intake?
Some people don’t tolerate excessive fibrous foods well. Stool softening and bulking agents are available. These products are plant fiber that absorb water and produce the bulk necessary for the digestive tract to perform naturally. Psyllium fiber is found in many commercial products such as Metamucil, Per Diem and Konsyl. The regular product contains a fair amount of sugar, so it may be preferable to use the sugar-free substitutes. Most pharmacies carry a generic brand at significant cost savings. Citrucel (hemicelulose) and Equilactin (polycarboxisal) are other bulking agents that can be used. These fiber supplements, in conjunction with foods, are a readily available way to reach the fiber goal of 20 to 35 grams per day.

What type of diet is best for people affected by Diverticulosis?
Colon diverticulosis occurs when pockets or sacks protrude from the bowel wall. It is known that these diverticula occur gradually over time and are due to excessive pressure of spasms within the bowel. These pockets usually cause no problem, but sometimes they can become infected (diverticulitis) or even perforate (abscess, peritonitis). A high-fiber diet may act to increase the bulk in the stool, thereby reducing pressure within the colon. By so doing, diverticula formation may be reduced or even stopped.