Objective: To assess the effect of high-fiber dietary instruction in relieving chronic constipation, a known and accepted complication of radical hysterectomy (RH).
Methods: Thirty-five women with a diagnosis of cervical cancer who were scheduled for RH were randomized into groups that followed either a high-fiber diet plan or their usual diet. Data were gathered using a validated subjective bowel function questionnaire (SBFQ); a typical day's intake form and food frequency tool; and a diary used to record food, medication, bowel, and exercise information. Patients were evaluated at 1, 4, and 7 months after surgery.
Results: Postoperatively, the dietary fiber intake was significantly higher for the treatment (T) group (22.9 g) than the control (C) group (12.4 g) (P = 0.007). With regard to intergroup comparisons, there were few differences at the first follow-up. By the second visit, the T group reported taking medications to achieve regularity less often (P = 0.0269), straining less often (P = 0.0210), having pain with bowel movement (BM) less often (P = 0.0116), and having crampy abdominal pain less often (P = 0.123) than the C group. Four significant positive changes occurred in the T group, whereas only one occurred in the C group. With regard to intragroup comparison, the significant changes in bowel function in the T group were generally positive, whereas all of the C group's significant changes were negative. According to summary questions on the SBFQ, the T group reported a significant change in the frequency of BM (P = 0.0096); however, the C group reported no significant changes. Analysis of bowel function records showed clearer differences. The T group took less time to defecate (P < 0. 001) but had more BMs accompanied by gas (P < 0.001). The C group had significantly more BMs with cramps (P < 0.001), straining (P < 0. 001), and retention (P < 0.001) and significantly more BMs, which were hard (P < 0.001). Two C patients dropped out of the study because of severe bowel dysfunction despite maximum medication.
Conclusion: Dietary management seems to be an inexpensive effective therapeutic intervention for addressing bowel dysfunction associated with RH.
Copyright 1997 Academic Press.