Testing the Effects of a High Fiber Instruction

Toward the end of my doctoral studies at the University of Virginia, I had the privilege of writing up the results of my interventional dissertation study and publishing the findings in the Gastroenterology Nursing journal.

The results were exciting for me to see. Just as I had witnessed the success of fiber in the diet of patients with Crohn’s disease earlier in my clinical practice, this dissertation study allowed me to see what happened in a formal study with an Institutional Review Board (IRB)-approved protocol and validated tools for measuring Crohn’s disease symptoms.

It was hard to find potential participants who were eligible for the study, because the protocol required an individual to be having Crohn’s disease symptoms, but he or she could not be using a biologic drug. The standard of care for IBD had recently moved toward earlier use of biologics. This change made it hard to find people who were having symptoms but were using no biologics.

During the time that I had for recruitment, I enrolled seven people. Four were randomized to the group that received the high fiber diet instruction. Three were randomized to the group that received a set of diet instructions focused on avoiding foods that seemed to bother them, and other recommendations people with Crohn’s disease commonly receive.

A comparison of the symptoms over time in the two groups showed statistically significant differences between groups, with the better outcomes in the high fiber group. In fact, all four participants in the high fiber group scored a zero on the partial Harvey Bradshaw Index at the end of the study, meaning that all the symptoms they had at baseline disappeared during the study.

Generally, it is hard to achieve statistically significant results in a small study, but results in this study were statistically significant. It speaks to the POWER of wheat bran.

Unfortunately, the study has been largely unnoticed in the world of research, because of the small sample size.1 The results of the study are almost completely unknown in the world of Crohn’s disease practice, because one article is like a minuscule drop in a vast ocean of research being published these days. Few individuals with Crohn’s disease will ever be exposed to the findings of my study, without a website such as stoolschool.org.

Despite being largely unknown, I relish the memory of the men and women in my study who appreciated receiving comprehensive fiber information. They got to see how fiber could work for them. What mattered most to each of those individuals was whether fiber worked in his or her body…

and it worked for all four of them.

Some experts like to say that “chance” caused four out of four participants to score a zero after 4 weeks, but that probably doesn’t matter to the participants who were able to enjoy the benefits of a functioning digestive system after years of dysfunction.

Title: A High-Fiber Diet May Improve Bowel Function and Health-Related Quality of Life in Patients With Crohn Disease

Authors: C Brotherton, A Taylor, C Bourguignon, J Anderson

Journal: Gastroenterology Nursing

Date: 2014

Volume/Issue/Page: 37(3),206-216

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