식이섬유의 섭취가 만성 기능성 변비에 미치는 영향

Effects of Fiber Supplements on Functional Constipation

  • 김지영 (연세대학교 노화과학연구소) ;
  • 김오연 (연세대학교 노화과학연구소) ;
  • 유현지 (연세대학교 식품영양학과) ;
  • 김태일 (연세대학교 의과대학 내과학교실) ;
  • 김원호 (연세대학교 의과대학 내과학교실) ;
  • 윤영달 ((주)크라운제과) ;
  • 이종호 (연세대학교 식품영양학과)
  • Kim Ji Young (Yonsei University Research Institute of Science for Aging, Yonsei University) ;
  • Kim Oh Yoen (Yonsei University Research Institute of Science for Aging, Yonsei University) ;
  • Yoo Hyun Ji (Department of Food & Nutrition, College of Ecology, Yonsei University) ;
  • Kim Tae Il (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim Won Ho (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Yoon Young Dal (Crown Confectionery Co., Ltd.) ;
  • Lee Jong Ho (Department of Food & Nutrition, College of Ecology, Yonsei University)
  • 발행 : 2006.01.01

초록

This study aimed to evaluate the effect of dietary fiber supplementation with snack type on functional constipation. We conducted a double blind case-control study with 3 groups; placebo, low dose group (LD: insoluble fiber 7 g/d + soluble fiber 1.2 g/d) and high dose group (HD: insoluble fiber 14 g/d + soluble fiber 2.4 g/d) , which were randomly assigned out of subjects with functional constipation, defined by modified Rome II criteria. We measured anthropometric parameters and evaluated the bowel movement frequency, stool type, straining, sense of complete evacuation, abdominal discomfort/pain, abdominal inflation, relief and colon transit time before, during the supplementation. Both LD and HD groups had significant improvement in straining, sense of complete evacuation and satisfactory relief compared with placebo group (p < 0.05). When subdivide by baseline colon transit time (less than 24 hrs/ 24 hrs or more and less than 72 hrs / 72 hrs or more), only HD group had significantly improvement; colon transit time recovered near by 24 hrs in subjects of 'less than 24 hrs' (from $7.57{\pm}1.40$ hrs to $25.2{\pm}3.91$ hrs, p < 0.01) and reduced in those of '24hr or more and less than 72 hr' (from $47.0{\pm}3.36$ hrs to $31.3{\pm}4.31$ hrs, p < 0.01) and '72 hr or more' (from $106.7{\pm}10.7$ hrs to $85.0{\pm}13.1$ hrs, P < 0.05) subjects. Particularly, positive effect of fiber supplementation on straining and sense of complete evacuation in test groups seemed to be greater in subjects of '24 hrs or less' and '24 hrs or more and less' than 72 hrs' than those of '72 hrs or more'. In conclusion, subjects with functional constipation, particularly those having colon transit time less than 72 hrs can significantly improve, at least in part, symptom related to constipation by fiber supplementation of snack type without serious side effects.

키워드

참고문헌

  1. Drossman DA, Richter JE, Talley NS, et al. The functional gastrointestinal disorders. 1st ed. Boston: Little, Brown and company, 1994
  2. Lembo A, Camilleri M. Chronic constipation. N Engl J Med 349: 1360-1368, 2003 https://doi.org/10.1056/NEJMra020995
  3. Chrn HL, Haack VS, Janecky CW, Vollendorf NW, Marlett JA. Mechanisms by which wheat bran and oat bran increase stool weight in humans. Am J Clin Nutr 68: 711-719, 1998 https://doi.org/10.1093/ajcn/68.3.711
  4. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut 45(Suppl 2): II43-47, 1999
  5. Metcalf AM, Philips SF, Zinsmeister AR, McCarty RL, Beart RW, Wolff BG. Simplified assessment of segmental colonic transit. Gastroenterology 92: 40-47, 1987 https://doi.org/10.1016/0016-5085(87)90837-7
  6. Astrup A, Vrist E, Quaade F. Dietary fibre added to very low calorie diet reduces hunger and alleriates constipation. Int J Obes 14: 105-112, 1990
  7. Rigaud D, Ryting KR, Leeds AR, Bard D, Apfelbaum M. Effects of a moderate dietary fibre supplement on hunger rating, energy input and faecal energy output in young, healthy volunteers. A randomized, double-blind, cross-over trial. Int J Obes 11: 73-78, 1987
  8. Dukas L, Willett WC, Giovannucci EL. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol 98: 1790-1796, 2003 https://doi.org/10.1111/j.1572-0241.2003.07591.x
  9. Cumming JH. Dietary fiber. Gut 14: 69-81, 1973 https://doi.org/10.1136/gut.14.1.69
  10. Davies GJ, Crowder M, Reid B, Dickerson JWT. Bowel function measurements of individuals with different eating patterns. Gut 27: 164-169, 1986 https://doi.org/10.1136/gut.27.2.164
  11. Martelli H, Devroede G, Arhan P, Duduay C, Dornic C, Faverdin C. Some parameters of large bowel motility in normal man. Gastroenterology 75: 612-618, 1978
  12. Harvey RF, Pomare EW, Heaton KW. Effects of increased dietary fibre on intestinal transit. Lancet 1: 1278-1280, 1973
  13. Williams RD, Olmsted WH. The manner in which food controls the bulk of feces. Ann Intern ed 10: 717-727, 1936 https://doi.org/10.7326/0003-4819-10-6-717
  14. Gear JSS, Brodribb AJM, Ware A. Mann JI. Fiber and bowel transit time. Br J Nutr 45: 77-82, 1981 https://doi.org/10.1079/BJN19810078
  15. Kim TI, Park SJ, Choi CH, Lee SK, Kim WH. Effect of ear mushroom (Auricularia) on functional constipation. Korean J Gastroenterol 44: 34-41, 2004
  16. Chung MG, Song CW, Moon JS, Jeen YT, Um SH, Kim CD, Ryu HS,Hyun JH. Effects of psyllium husk on slow transit constipation. Korean J Gastroenterol 28: 513-519, 1996
  17. Lee SI. Treatment of constipation. Korean J Gastroenterol 40 (suppl 1): 37S-47S, 2002
  18. Kang YW. Drug treatment of constipation. Korean J Gastrointest Motil 5: 227-240, 1999
  19. Dettmar PW and Sykes J. A muti-centre, general practice comparison of Ispaghula husk with lactulose and other laxatives in the treatment of simple constipation. Current Medical Research and Opinion 14(4): 227-233, 1998 https://doi.org/10.1185/03007999809113363
  20. Corazziari E, Badiali D, Bazzocchi G, Bassotti G, Roselli P, Mastropaolo G, Luca MG, Galeazzi R, Peruzzi E. Long term efficacy, safety, and tolerability of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation. Gut 46: 522-526, 2000 https://doi.org/10.1136/gut.46.4.522