SOLUBLE FIBER SELECTION FOR PEDIATRIC BOWEL MANAGEMENT: EXPERIMENTAL COMPARISON AND PRACTICAL GUIDELINES

Marion Arnold [1], Arthur Schmidt [1,2], Lisarae Ungerer [3], Stephanie Harris [3],

Nosandiswa Dlamini [1], Hannah Levy [1], Maloma Makashe [1], Patience Mojapelo [1],

Naidoo Nikkia [1], Rachel Otter [1], Ratshivombela D [1], Alexandra Van Stelten [1]

[1] Red Cross War Memorial Children’s Hospital, Division of Pediatric Surgery, Faculty of Health Sciences, University of Cape Town, South Africa

[2] Philipps University of Marburg, Germany

[3] Division of Neurosurgery, Neuroscience Institute, University of Cape Town, South Africa

Abstract

Introduction: Soluble fiber dietary supplements are used to optimize bowel management in patients with colorectal disorders causing both constipation and incontinence. Availability, effectiveness and cost of these in South Africa is. The aim of this study was to identify the most absorptive and cost-effective

commercially available sources of soluble fiber in South Africa.

Methods: Swelling and water retention capacity of 18 soluble fibers were measured under room temperature and boiling water conditions at three dwell times (10, 60, 120 minutes). Cost and texture comparisons were also made.

Results: Psyllium husks, guar gum, flaxseed flour and chia seeds had the best water retention capacity at room temperature. Heat improved the water retention of most substrates, notably Agar Agar

and flaxseed powder. The most cost-effective options that had good water retention properties were flaxseed powder, psyllium husks and chia seeds. Oat bran was cheaper but notably less retentive.While xantham gum, guar gum, pectin and Agar Agar have moderate to good water retention properties, high costs and limited

availability preclude their widespread use in the South African setting. Digestive bran, whole flaxseeds, cacao, resistant maltodextrin, baobab powder and pectin-kaolin mix had relatively poor water retention.

Conclusion: This bench study identified the most effective and affordable soluble fiber in South Africa as psyllium (ispaghula) husk, flaxseed flour (powder) and chia seeds. Clinical research on their tolerance and use in the pediatric population for bowel management is recommended. These findings inform dietary guidelines and support the integration of effective, low-cost soluble fiber sources into pediatric bowel management strategies