If patient has history of constipation or hard bowel movements, attempt should be made to correct this, as it may have been causative.
A high fiber diet can be achieved by daily use of a high fiber cereal (i.e., All-Bran, Fiber One, Bran Buds, Kashi cereals with >10 grams of fiber per serving) ? to 1 cup of cereal daily.
by using a fiber supplement (i.e., Metamucil, Citrucel, Benefiber, etc.). A sufficient amount must be taken daily to give 10-20 grams of fiber. This usually means tablespoons not teaspoons of supplement.
The added fiber must be taken every day. It is not a cathartic. Beneficial effects take days to weeks as the colon adapts to the new diet.
Miralax is another alternative, but should be reserved for patients who cannot tolerate or are unable to manage a high fiber diet.
For patients with severe, chronic constipation, or in whom one is concerned about dysmotility, referral to the Michigan Bowel Control Program is suggested.