Whether it’s the knotted ache of constipation or the burning urgency of diarrhea, most of us know a thing or two about tummy troubles. After all, according to the National Institutes of Health (NIH), about 16 out of 100 U.S. adults have symptoms of constipation, including about 33% of adults over the age of 60.
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At the other, uh, end of the spectrum, about 179 million U.S. adults are sitting on the toilet with the runs in any given year. And then there are the people who alternate between the two — symptoms that are not only a literal pain in the butt, but also a classic sign of irritable bowel syndrome (IBS), a condition that affects between 25 million and 45 million Americans.
The good news is that all of these common conditions can be helped with fiber supplements. The bad news is that finding the best fiber supplement for your particular body can be a challenge.
Gastroenterologist Christine Lee, MD, talked with us about the safest, most effective way to find the fiber supplement that works best for you.
If you’re like most Americans, you probably do.
Dietary guidelines from the U.S. Department of Agriculture (USDA) and the U.S. Department of Health and Human Services recommend consuming between 22 and 34 grams of fiber a day depending on your age and sex assigned at birth.
Yet studies show that only about 5% of American adults get enough fiber in their diets, with the average person getting a mere 16 grams a day.
While it’s always best to try to get your fiber by eating fruits, vegetables, whole grains, beans and other legumes, it’s pretty clear that most of us aren’t doing that. In which case, you might decide to add a fiber supplement to your daily routine.
You wouldn’t be alone in doing so. In fact, says Dr. Lee, “Anyone who has had a medical diagnosis of irritable bowel syndrome, as well as people who suffer from abdominal discomfort like constipation, diarrhea, abdominal distension, bloat, gas — any of those folks would probably benefit quite a bit from fiber therapy.”
“All fiber supplements work toward a common goal,” says Dr. Lee, “which is helping you go to the bathroom better.”
But here’s where things get tricky. There are a lot of different types of fiber supplements on the shelf — and not all of them are right for every person. Figuring out which one is best for you can be challenging.
To begin with, supplements generally contain one of two major types of fiber. They serve similar purposes in your body but function a little differently:
Fiber can also be fermentable, meaning it helps feed the friendly gut bacteria. Soluble fiber is usually fermentable, but some insoluble fibers are fermentable, too.
Common types of fiber found in supplements include:
The fiber in supplements can be natural (meaning it comes directly from plant sources, like flaxseed) or synthetic (meaning it results from at least some amount of processing or modification, like methylcellulose).
When shopping for supplements, you’ll see they come in a variety of forms:
Here are a few other things to know about fiber supplements:
Overall, it’s not an easy landscape to navigate.
“Thank goodness we have so many choices,” says Dr. Lee. “But clearly, there is no ‘one-size-fits-all’ solution. Each person’s symptoms are different, and every type of fiber supplement — whether it’s a pill or a powder, soluble or insoluble — offers its own particular nuances.”
So, before you decide to simply settle for the supplement with the most colorful label, the lowest price or the highest ratings on Amazon, Dr. Lee says to consider this: Talk to your healthcare provider.
“Let them know what’s going on,” she says. “Are your symptoms primarily constipation, diarrhea, or a little of both? Or maybe you are bothered by gas and bloating more than by either diarrhea or constipation.
“Is it the frequency of your bathroom visits that’s bothering you or is it the urgency? Have your symptoms bothered you all your life or have they just started? And what other medical conditions are you being treated for that could be affecting you?”
All these questions can play a role in determining which supplement is right for your particular situation.
“My best recommendation is to talk with your primary healthcare provider and let them be your guide,” reiterates Dr. Lee.
There’s another reason why a conversation with your healthcare provider is a good place to start
“Ten to 15% of the people with intestinal complaints may have organic diseases like colon cancer or inflammatory bowel disease,” Dr. Lee explains. “So, if you have symptoms that are bothering you or interfering with your lifestyle, then your body is saying that something is wrong and needs to be checked out.”
It’s the opposite of the legal adage, “innocent until proven guilty,” she continues. “In medicine, we have to assume your symptoms are ‘guilty’ until we can prove them ‘innocent.’ But once we’ve been able to find them ‘innocent’ — that is, once we’ve been able to rule out organic diseases — then, we can move on to other treatments. And that’s the time when fiber supplements are likely to be most helpful.”
Even though dietary fiber offer a host of health benefits, most of us fall short of getting enough. Fiber supplements can be very helpful in those cases, especially to help manage bowel issues like constipation and diarrhea.
Choosing the right one is important, though, and your healthcare provider can be your top resource, pointing you toward the best supplement for your symptoms and discussing issues like when and how often to take it.
And while they’re at it, your healthcare provider can rule out serious diseases that might be behind your symptoms, like colon cancer or inflammatory bowel disease.
“We don’t want to use scare tactics,” reassures Dr. Lee, “but colon cancer is the third-most common cancer, and the second leading cause of cancer death, in the United States. So, it’s always worth a trip to your healthcare provider to rule that out. And once you’ve been cleared, then you have all the time in the world to figure out which supplement is right for you.”
This is why there aren’t blanket recommendations for which fiber supplement to take.
“Everybody is different, and what’s helpful for one person might even be harmful to another,” stresses Dr. Lee. Again, she recommends choosing your supplement with the help of a provider, whether that’s your primary care doctor or a gastroenterologist.
“Let them be your tour guide,” she encourages. “You don’t have to wing it alone.”