Dietary fibre and peptic ulcer

Abstract

Until some years ago dietary regulations constituted the most important part of peptic ulcer treatment. The clinical value of the traditional, bland, low-fibre diet has never been documented. A survey is given of the influence of a high-fibre diet on peptic ulcer disease. Studies evaluating the effect of a high-fibre diet in the treatment of gastric and duodenal ulcer as well as the prophylactic effect on duodenal ulcer recurrence are reviewed. Experimental studies in vitro and in vivo have been performed to look at the possible mechanisms by which fibre could innfluence ulcer diathesis. The fibre components, guar gum (Guarem) and fibre-enriched wheat bran (Fiberform) effectively bind bile acids in gastric juice both in vitro and in vivo. The bile acid binding in vivo is effective not only in healthy subjects but also in patients with gastric ulcer. Fibre-enriched wheat bran prolongs the meal-induced pH elevation and reduces postprandial pepsin concentrations. The fibre-induced alterations of in-tragastric pH and pepsin are not due to alterations of gastric emptying as physiological doses of the fibre components mentioned do not influence the gastric emptying of a semi-solid meal in healthy subjects.

The clinical studies revealed a prophylactic effect of a high-fibre diet in the prevention of duodenal ulcer relapse. However, in the treatment of acute gastric and duodenal ulcer, there seems to be no obvious advantage in the use of a high-fibre diet compared with the traditional bland diets.