Fecal incontinence (FI), the involuntary leakage of feces, is a chronic problem with debilitating effects on health and well-being. Symptom management of FI is essential to maintain the dignity, self-esteem, and health of the individual, ease the burden of caregivers, and prevent admission to a nursing home. FI is worsened by loose/liquid stool consistency and the first step in its management is to firm stool consistency. The proposed study addresses a major gap in clinical management of FI since there is a lack of research on interventions to firm stool consistency in FI. The beneficial effects of fiber on stool consistency and FI appear to be related to the extent to which the fiber is fermented. A pivotal step in optimizing fiber therapy and improving the clinical response is to determine the importance of fermentation of fiber. The long-range objectives of this research are 1) to develop evidenced-based recommendations for using soluble dietary fiber to effectively manage FI and 2) to determine the mechanisms by which soluble dietary fiber improves stool consistency and FI. The objectives of this proposal are to determine the impact of fermentation on a fiber's ability to firm stool consistency, reduce FI, promote supplement tolerance, and improve quality of life in community-living adults with FI of loose or liquid stools. A randomized, controlled, single blind between groups design will be used. After a 2 wk. Baseline period, 184 community-living adults with FI of loose/liquid stool will be randomized to receive placebo or 16 g of total fiber/d in gum Arabic, psyllium, or carboxy-methylcellulose, representing three levels of ferment ability (completely, moderately, and non-fermentable, respectively). During the baseline and at the end of the supplementation period, subjects will complete a stool diary (14d), diet record (7d), FI Quality of Life survey, and collect all stools (7d). Differences among the measures of the groups after supplementation will be compared after controlling for baseline values of these measures using ANCOVA.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR007756-04
Application #
7029724
Study Section
Nursing Research Study Section (NURS)
Program Officer
Bakos, Alexis D
Project Start
2003-06-01
Project End
2008-02-29
Budget Start
2006-03-01
Budget End
2007-02-28
Support Year
4
Fiscal Year
2006
Total Cost
$504,164
Indirect Cost
Name
University of Minnesota Twin Cities
Department
Type
Schools of Nursing
DUNS #
555917996
City
Minneapolis
State
MN
Country
United States
Zip Code
55455
Bliss, Donna Zimmaro; Funk, Taylor; Jacobson, Megan et al. (2015) Incidence and Characteristics of Incontinence-Associated Dermatitis in Community-Dwelling Persons With Fecal Incontinence. J Wound Ostomy Continence Nurs 42:525-30
Bliss, Donna Z; Savik, Kay; Jung, Hans-Joachim G et al. (2014) Dietary fiber supplementation for fecal incontinence: a randomized clinical trial. Res Nurs Health 37:367-78
Rohwer, Kristi; Bliss, Donna Z; Savik, Kay (2013) Incontinence-associated dermatitis in community-dwelling individuals with fecal incontinence. J Wound Ostomy Continence Nurs 40:181-4
Bliss, Donna Z; Weimer, Paul J; Jung, Hans-Joachim G et al. (2013) In vitro degradation and fermentation of three dietary fiber sources by human colonic bacteria. J Agric Food Chem 61:4614-21
Bliss, Donna Z; Savik, Kay; Jung, Hans-Joachim G et al. (2011) Symptoms associated with dietary fiber supplementation over time in individuals with fecal incontinence. Nurs Res 60:S58-67
Bliss, Donna Z; Lewis, Jaclyn; Hasselman, Keegan et al. (2011) Use and evaluation of disposable absorbent products for managing fecal incontinence by community-living people. J Wound Ostomy Continence Nurs 38:289-97
Croswell, Emily; Bliss, Donna Z; Savik, Kay (2010) Diet and eating pattern modifications used by community-living adults to manage their fecal incontinence. J Wound Ostomy Continence Nurs 37:677-82
Patel, Kristina; Bliss, Donna Z; Savik, Kay (2010) Health literacy and emotional responses related to fecal incontinence. J Wound Ostomy Continence Nurs 37:73-9
Whitebird, Robin R; Bliss, Donna Zimmaro; Savik, Kay et al. (2010) Comparing community and specialty provider-based recruitment in a randomized clinical trial: clinical trial in fecal incontinence. Res Nurs Health 33:500-11
Manthey, Amanda; Bliss, Donna Z; Savik, Kay et al. (2010) Goals of fecal incontinence management identified by community-living incontinent adults. West J Nurs Res 32:644-61

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