Soluble fiber is the key to preventing the abdominal spasms and bowel dysfunction of IBS. This is true not just for soluble fiber foods but supplements as well.
Remember, soluble fiber works by absorbing liquids in the digestive tract to form a stabilizing gel that relieves cramping and prevents both IBS diarrhea and constipation. Clinical studies with IBS patients have repeatedly proven the benefits of soluble fiber supplements. Some soluble fibers are also prebiotic, which means they encourage the growth of healthy bacteria (probiotics) in the gut.
Please ignore the fact that some soluble fiber supplements are marketed as laxatives - they are NOT. They will of course relieve and prevent IBS constipation, but they are just as effective at treating IBS diarrhea, and they will not compromise normal bowel function at all once your IBS is under control - they'll simply keep things normal.
Soluble fiber will, in fact, work beautifully to keep your GI tract running smoothly, comfortably, and IBS pain-free on a day-to-day basis.
Best of all, there is nothing to show that soluble fiber supplements can't simply be taken daily forever with no harmful side effects or risk of addiction. In fact, soluble fiber has health benefits far beyond managing IBS. Soluble fiber (from both foods and supplements) not only normalizes bowel function, it has also been shown to lower LDL ("bad") blood cholesterol levels, reduce the risk of heart disease, and minimize colon cancer risks. Soluble fiber also slows the absorption of fats and carbohydrates into the bloodstream, which improves glycemic control and helps prevent the formation of free radicals. It also lowers insulin requirements.
Other common brands of soluble fiber supplements are Equalactin, FiberChoice, Fibersure, Benefiber, Metamucil, Konsyl, Fybogel, Citrucel, and Fibercon. Most are widely available at drug stores and pharmacies, and they don't require a prescription (they are not drugs, just fiber - most are labeled as dietary supplements).
Tummy Fiber is organic acacia senegal.
Metamucil, Konsyl and Fybogel contain psyllium, which is actually NOT a completely soluble fiber, but is about 2/3 soluble and 1/3 insoluble.
Citrucel contains methylcellulose, a synthetic fiber. I would not choose to ingest something synthetic when there are so many natural fibers, including certified organic options, available instead.
Equalactin and Fibercon also ontain a synthetic fiber, calcium polycarbophil. Benefiber in the USA contains wheat dextrin. Pre-2006 Benefiber contained guar gum (and in Canada, inulin). Both FiberChoice and Fibersure contain inulin.
These supplements are available as powders that you mix with water and drink, or as caplets that are either chewable or meant to be swallowed whole with a glass of water. Tummy Fiber Acacia Senegal is pure soluble fiber - most other brands contain fillers, binders, sweeteners, or other added ingredients.
If you're at all prone to bloating or gas (and many folks with IBS are), please avoid both psyllium - also called isphagula - and inulin (the main ingredients in Metamucil, Konsyl, Fybogel, Fibersure, FiberChoice, and Canadian Benefiber). The insoluble fiber in psyllium and the very rapid fermentation of inulin in the gut can seriously worsen bloating and gas in some people with IBS. Try another soluble fiber variety (particularly prebiotic Heather's Tummy Fiber™, which has been found to have excellent gastrointestinal tolerance and to increase good gut flora) instead.
Also, be aware that the sugar-free versions of the soluble fiber supplements such as Metamucil, Citrucel, and FiberChoice can contain artificial sweeteners, which can trigger diarrhea, gas, and cramps. In addition, citric acid is often added to orange-flavored supplements such as Citrucel and Metamucil, and this can cause acid reflux in susceptible people (though it may not bother IBS). Finally, many brands add artificial flavors, colors, and additives, particularly Citrucel, Metamucil, and the fruit flavored varieties of Benefiber, which are of no benefit to your gut whatsoever and carry the risk of causing GI upsets.
The best bet for a fiber supplement for IBS symptoms is one that contains nothing whatsoever but a naturally sourced, pure soluble fiber. That is the only thing your gut needs in a fiber supplement, and you won't run the risk of nasty bowel side effects from unnecessary and artficial additives. Nor will you have to worry about ingesting synthetic substances.
Aside from the high likelihood of bloating and gas with psyllium (isphagula) and inulin, there is a great deal of individual variation here in how someone responds to any particular soluble fiber supplement. So if you have gas or bloating from starting a supplement that doesn't disappear after a week or so, don't be discouraged, just try a different brand and perhaps a different formulation (the pills instead of powder, or vice versa).
It may take several different tries to find the soluble fiber supplement that works best for you, but the results will be well worth the effort. It's also crucial that you start at a low dose and increase gradually, to give your gut time to adjust to the fiber increase.
To initially stabilize yourself, try taking a soluble fiber supplement first thing in the morning as soon as you awake, before meals, and again before bedtime. Follow the dosage recommendations on the bottles and remember - start at a low dose and gradually increase your intake. Don't be afraid to try both the powders and caplets, and a variety of brands, as people's preferences and tolerances vary widely here. You can also feel free to mix and match different soluble fiber supplements.
Some folks prefer to take the powders at home but carry travel packets or caplets with them in their purse or pocket, keep them in the car, and hide a stash in their desk drawer at work. The supplements are great to have on hand when you find yourself unexpectedly eating out, going too long between meals, or just feeling a little shaky. Taking a soluble fiber supplement with a large glass of tepid water or IBS-friendly herbal tea will always give you extra protection against attacks in dicey situations.
Remember that different people have varying tolerances and adjustment periods to soluble fiber supplements; this means that it can take several days to two weeks for your body to adjust to the increased fiber intake. Your symptoms should NOT dramatically worsen during this introductory period, and you may well see immediate improvement, but if you don't notice any difference the first day or two have patience. Soluble fiber may be the single greatest aid for controlling IBS symptoms you'll ever find, so give it a fair chance.
What's most confusing to many folks with IBS about soluble fiber supplements is that several major brands (Metamucil, Citrucel, Fibercon, Equalactin) are marketed as over-the-counter laxatives. This means that they're bound by the FDA prescribing guidelines for those products. As a result, the supplements must have the dosage limitations on their packaging that apply to OTC anti-diarrheal and laxative drugs, even though they are not drugs but soluble fiber. The FDA packaging guidelines for this category do not discriminate between drugs and soluble fiber. This explains why the dosages for these products that your doctor recommends for IBS may conflict with the package information.
On the other hand, soluble fiber supplements that are not marketed as laxatives (Benefiber, FiberChoice), but simply as dietary fiber, are not allowed to make label claims comparable to the claims the FDA permits for laxatives. Products marketed as dietary fiber can only make claims that pertain to the structure/function of the body; otherwise, the FDA would consider these products to be drugs and not soluble fiber dietary supplements.
The dosage information for IBS below is from soluble fiber supplement manufacturers:
Start at 1/2 - 1 level teaspoon twice a day and over the next week or two (or three or four) work up to 2-4 tablespoons twice a day, or the equivalent of 12-25 grams of soluble fiber supplement per day. Some people may need less than this (typically for diarrhea) and some folks may need up to 30 grams per day (typically for chronic constipation). Just keep gradually increasing your dose until you stabilize, and then stay there. Please note that different manufacturers may have different maximum dosages on their labels. Check with the individual manufacturer if you are exceeding the dosage they recommend.
Start at 2 pills or 1 travel packet twice daily. Gradually work up to 2 pills six times daily, or 2 travel packets three times daily. Continue working up to the equivalent of 12-15 grams soluble fiber supplement per day. I do not recommend Benefiber chewable tablets, as they contain sorbitol, an artificial sweetener that can cause cramps, bloating, diarrhea, and gas in people who don't even have IBS - imagine what they can do to you. As with the fiber powders, the goal with the fiber pills and packets is to just keep gradually increasing your dose until you stabilize, and then stay there. Please note that different manufacturers may have different maximum dosages on their labels. Check with the individual manufacturer if you are exceeding the dosage they recommend.
The grams of soluble fiber per teaspoon/tablespoon/pill dose of the different supplements will vary (for example, one Fibercon pill provides just 1/2 gram of soluble fiber, but 1 level tablespoon of Heather's Tummy Fiber Acacia Senegal provides 6 grams). Check the label of your own supplement for this information, and then calculate your dose in fiber weight by grams instead of by volume.
Don't hesitate to divide your doses throughout the day however you like; it's always better to keep your gut constantly filled with soluble fiber, so several smaller doses are often much more helpful than a single large daily dose.
The USDA recommended minimum fiber intake for adults is 25 to 35 grams daily, and soluble fiber should account for one third to one half of this total amount. Some scientists actually recommend up to 60 grams of fiber a day, so the USDA recommendations are not maximum dosage limitations. The typical American eats only a meager 10-15 grams of fiber daily. For comparison, the average fiber intake in China is 33 grams of fiber a day, and it ranges as high as 77 grams per day in some regions.
Dosages and fiber content for common soluble fiber supplements:
Benefiber powder provides 1.5 grams of soluble fiber per teaspoon (please note that Benefiber has at times changed their ingredients.)
One tablespoon of Metamucil smooth texture orange and original texture orange (these are not the sugar-free varieties) contains 2 grams of soluble fiber and 1 gram of insoluble fiber.
One tablespoon of Citrucel provides 2 grams of soluble fiber.
Two Metamucil wafers provide 2 grams soluble fiber and 1 gram insoluble fiber.
Two Fibercon tablets contain 1 gram soluble fiber.
Two Equalactin tablets contain 1 gram soluble fiber.
Two FiberChoice tablets contain 4 grams soluble fiber
Two Citrucel caplets provide 1 gram of soluble fiber.
Read labels carefully - manufacturers have to list the soluble fiber content of their supplements accurately. Keep in mind that soluble fiber supplements that contain sugar, artificial sweeteners, citric acid, binders, and other added ingredients can give you a dose that is as high as 90% filler and only 10% soluble fiber. What you want to keep your eye on here is the amount of grams of soluble fiber you're really getting in a dose - because the soluble fiber is what will actually help your gut function.
Don't be afraid to mix and match the powders and pills or packets (for example, take the powders at home but keep the travel packets or pills on you at work or for taking before restaurant meals). If you're combining powder and pill supplements, it's definitely best to make sure that your total daily dosage is equal to what it should be for just the pills or fibers alone. You don't want to take the maximum dose for the pills and then take the maximum dose for the powders on top of this. Please note that the supplements are not meant to be the main source of soluble fiber in your diet - they are an addition to the fiber you need to be eating (both soluble and insoluble) from foods.
If you do not see a measurable improvement in your IBS symptoms within one week (for diarrhea), or one month (for constipation) of using the maximum dosage of a soluble fiber supplement, this could certainly point to a problem other than IBS, and you should see your doctor again. If you have any questions or concerns about the dose and frequency of taking soluble fiber supplements, check with your own physician.
If you're wondering about taking medications with a soluble fiber supplement, the general rule is to treat the supplements like food. If you can take a medication with food, you can take it with the supplement. If you have to take the medication on an empty stomach, then take it one hour before or two hours after your fiber supplement. As an aside here, if you're taking vitamins/minerals you can always take them with a soluble fiber supplement, but you should also always take vitamins/minerals with food for the best absorption.
For all soluble fiber supplements, make sure you have a large glass of water with each dose, and drink fresh water frequently throughout the day as well. Soluble fiber needs plenty water to work - this is essential. You should be able to take soluble fiber supplements every day for the rest of your life and it will only help your IBS, as well as offer numerous other health benefits.