Sixty three patients with chronic constipation were taken off fibre completely, and the result has been sitting in a journal since 2012 doing absolutely nothing. Everyone had been scoped first to rule out a physical cause. All had the standard advice behind them, which is to say all had been told to eat more fibre for years. Two weeks on zero fibre. Then each was allowed to settle at whatever intake they found tolerable, and they sorted themselves into three groups. The ones who stayed off fibre entirely went from a motion every 3.75 days to one every single day. Every one of them. The ones who merely cut down went from a motion every 4.19 days to one every 1.9 days. The ones who stayed on high fibre stayed at one motion every 6.83 days, before and after, unchanged, like a control group that had volunteered for nothing. Bloating was present in nought per cent of the no fibre group, thirty one per cent of the reduced group, and one hundred per cent of the high fibre group. Straining ran the same way. A dose response, running in the exact opposite direction to the advice printed on every cereal box in Britain. Insoluble fibre works by adding bulk. In a colon already struggling to move what is in it, the intervention is to put more in it. The whole doctrine traces back to one surgeon in the 1970s comparing British bowels with Ugandan ones and drawing a conclusion the food industry found extremely convenient.Sixty three patients with chronic constipation were taken off fibre completely, and the result has been sitting in a journal since 2012 doing absolutely nothing.
— Sama Hoole (@SamaHoole) August 28, 2026
Everyone had been scoped first to rule out a physical cause. All had the standard advice behind them, which is to say… pic.twitter.com/bHua87C7iw
Fifty years later the bran is still on the shelf, the bloating is still assumed to be normal, and the treatment for a blocked tube is still to add material to it.
