FIBER
Patient Counselling
Fiber should be incorporated into the treatment of
hemorrhoids to help alleviate constipation and pruritis associated with
hemorrhoids. Fiber can be obtained from the diet through foods including fruits
such as raspberries and vegetables such as peas and broccoli, as well as whole
grain products. Over the counter fiber supplementation is another option for
patients looking to relieve constipation and help heal their hemorrhoids.
Products include psyllium fibre, polycarbophil calcium, methylcellulose, and
bran. Patients should start at a low dose for these products and gradually
increase the dose so that they are receiving a maximum of 20-30mg of fiber per
day (in adults). It should be noted that these supplements should not be taken
within two hours of other medications as it may affect their absorption and
thus their effectiveness.
Overall these products are usually well accepted by patients but some common side effects including bloating and flatulence. It is important that patients also drink plenty of fluids. Psyllium fiber should not be used if the patient has a mechanical obstruction in their gastrointestinal tract. It is also contraindicated in patients who must restrict their fluid intake. It may take some patients 2-3 months to achieve an optimal outcome when taking psyllium fiber but the onset of action is 12-72h. Dosing for bulk forming agents is shown below:
Overall these products are usually well accepted by patients but some common side effects including bloating and flatulence. It is important that patients also drink plenty of fluids. Psyllium fiber should not be used if the patient has a mechanical obstruction in their gastrointestinal tract. It is also contraindicated in patients who must restrict their fluid intake. It may take some patients 2-3 months to achieve an optimal outcome when taking psyllium fiber but the onset of action is 12-72h. Dosing for bulk forming agents is shown below: