It is well-known that fibre is an important part of any diet. There are different types of fibre, each benefiting the body in a different way. Soluble fibres mix with water in the intestine to form a gel-like substance, which acts as a trap to collect certain body wastes and then move them out of the body. Insoluble fibres absorb and hold water, producing uniform stool and helping to push content of the gut through the digestive system quickly. Insoluble fibres promote regularity and treat constipation.

The Consortium for Spinal Cord Medicine (1998) recommends an initial diet with no less than 15 grams of fibre daily, and the MASCIP (2009) group identify an average intake of 18 grams, however, acknowledge that adjustments should be made if problems arise with stool consistency. The most common source of dietary fibre is bran.  It is not recommended to place individuals with SCI on high fibre diets (Consortium for Spinal Cord Medicine, 1998

Table 3: Dietary fibre for managing neurogenic bowel after a spinal cord injury

Discussion

Results of this study suggest that increasing dietary fibre in SCI patients does not have the same effect on bowel function as has been previously demonstrated in individuals with normal-functioning bowels. The effect may actually be the opposite of the desired result (Cameron et al. 1996). Therefore, adding more fibre alone does not improve bowel function, however, more evidence is required to assess the effectiveness of adding fibre to diets.

Conclusion

• There is level 4 evidence (from 1 case series; N=11) (Cameron et al. 1996) that indicates high fibre diets may lengthen colonic transit time.

• There is a need for further research to examine the optimal level of dietary intake in spinal cord injured patients.