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Prospective Evaluation of Dietary Treatment in Childhood Constipation: High Dietary Fiber and Wheat Bran Intake Are Associated With Constipation Amelioration

Maffei, Helga Verena Leoni*; Vicentini, Andréa Pereira

Journal of Pediatric Gastroenterology and Nutrition: January 2011 - Volume 52 - Issue 1 - p 55–59
doi: 10.1097/MPG.0b013e3181e2c6e2
Original Articles: Gastroenterology

Objectives: The aim of the study was to evaluate, over 24 months, the intake of dietary fiber (DF) and the bowel habit (BH) of constipated children advised a DF-rich diet containing wheat bran.

Patients and Methods: BH and dietary data of 28 children with functional constipation defined by the “Boston criteria” were obtained at visit 1 (V1, n = 28) and at 4 follow-up visits (V2–V5, n = 80). At each visit the BH was rated BAD (worse/unaltered; improved but still complications) or RECOVERY (REC) (improved, no complications; asymptomatic), and a food intake questionnaire was applied. DF intake was calculated according to age (year)+5 to 10 g/day and bran intake according to international tables. Nonparametric statistics were used.

Results: Median age (range) was 7.25 years (0.25–15.6 years); 21 children underwent bowel washout (most before V1/V2), and 14 had the last visit at V3/V4. DF intake, bran intake, and the BH rate significantly increased at V2 and remained higher than at V1 through V2 to V5. At V1, median DF intake was 29.9% below the minimum recommended and at the last visit 49.9% above it. Twenty-four children accepted bran at 60 visits, at which median bran intake was 20 g/day and median proportion of DF due to bran 26.9%. Children had significantly higher DF and higher bran intake at V2 to V5 at which they had REC than at those at which they presented BAD BH. DF intake >age+10 g/day was associated with bran acceptance and REC. At the last visit 21 children presented REC (75%); 20 of them were asymptomatic and 18 were off washout/laxatives.

Conclusions: High DF and bran intake are feasible in constipated children and contribute to amelioration of constipation.

*Pediatric Gastroenterology, the Department of Pediatrics, Brazil

Department of Internal Medicine, Botucatu Medical School, UNESP-São Paulo State University, Botucatu, SP–Brazil.

Received 30 October, 2009

Accepted 11 April, 2010

Address correspondence and reprint requests to Helga Verena Leoni Maffei, MD, PhD, Rua Engenheiro Edgar Egídio de Souza 303 apt. 51, 01233-020 São Paulo, SP—Brasil (e-mail:

The authors report no conflicts of interest.

Copyright 2011 by ESPGHAN and NASPGHAN