Whats a difference between the role of soluble and insoluble fiber in the pathogenesis of IBS?
Insoluble fiber (bulking agent) makes stools large. Large stools induce straining, straining causes the enlargement of internal hemorrhoids, enlarged hemorrhoids cause incomplete emptying, incomplete emptying causes impacted stools, impacted stools cause abdominal cramps. Soluble fiber (hydrophilic mucilloid) blocks the absorption of digestive fluids. Blocked fluids, including astringent bile and omnivorous enzymes, slip down into the large intestine, and wreak havoc there. To cleanse itself of irritants and impacted stools, the large intestine responds with profuse diarrhea. When the diarrhea is over, the colon’s examination shows no visible damage. Back on fiber, and the cycle starts again. Both fibers are fermentable. If the bacteria level is normal, soluble fiber ferments 100%, insoluble about 50% with normal motility, almost 100% with slow motility (common in IBS). In the overall scheme of things, soluble fiber is by far more damaging then insoluble, except in the cases of (a) inf
