Efficacy of a Plant-based Diet (Semi-lacto-ovo-vegetarian Diet) for Treating Constipation

Abstract

A modern lifestyle, including dietary westernization, has increased the prevalence of constipation. The authors developed a plant-based diet for inflammatory bowel disease. This study investigated whether a diet containing a high amount of dietary fiber is also effective for constipation. Consecutive patients with constipation were recruited in this study from April 2003 to March 2004. Their constipation was unresponsive to a conventional laxative. The patients were provided a plant-based diet during hospitalization for around two weeks. The plant-based diet was a semi-lacto-ovo-vegetarian diet: unrefined whole brown rice, fish once a week, and meat once every two weeks. The diet contained 29.9±1.9 g of dietary fiber/1,700 kcal. The plant-based diet score, where a higher score indicates greater adherence to the plant-based diet, was 35. A diet of 30 kcal/kg of standard body weight was provided. Defecation within two days with the diet alone or in combination with laxatives was regarded as highly effective and effective, respectively. Eleven patients (three men and eight women, 16 to 92 years old; median age: 70 years) were included; seven patients had no complications of constipation, but the remaining four patients had complications that included fecal impaction, megabowel, colonic pseudo-obstruction, and abdominal distention. Among the seven patients with uncomplicated constipation, the diet was highly effective in six patients and ineffective in one patient. It was effective in all four patients with complicated constipation. There were no adverse effects of the diet. The mean plant-based diet score before hospitalization in nine cases was 18.0. A clinical path of 13 days of hospitalization for the management of uncomplicated constipation was designed. The plant-based diet was safe and highly effective for uncomplicated constipation and effective for complicated constipation. A plant-based diet can be introduced as a special meal in a hospital setting for patients suffering from serious constipation.