Thickening foods/slowing transit

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  • Pectin is a soluable fiber that is supposed to be good for thickening/slowing transit. It is also thought to have properties that help promote intestinal adaptation. Pectin can be purchased in the canning section of stores (also online at amazon.com) -it's used to thicken jams and jellies. Make sure to buy the liquid form as the powdered form of Pectin has sugar in it. The accepted dose of Pectin, as a dietary supplement for short gut syndrome, is to mix 3 ml. of liquid pectin per 100 ml of formula. Pros: flavorless; can be added to tube feeds without clogging the pump
  • Commercial grade fiber -- made from partially hydrolyzed guar gum, and ordered through home health care companies. This may be more effective than over-the-counter fibers like Benefiber.
  • Benefiber - made from wheat dextrin. Benefiber is suppose to work better for kids with a colon; for kids without, it may not be very effective and can even increase outputs. However, it seems to vary from kid to kid, so it may be worth trying. We gave AustinRath Benefiber for a week, then discontinued it for a week, then added it back again and then discontinued it again (ABAB design) and then averaged his outputs on Benefiber and off. We found that Benefiber increased his outputs by about 10%. MaxMunakata used to get 1 teaspoon of Benefiber per 100cc of formula, but a preliminary test (ABA design only) suggested that it also increased his outputs by about 10%. Pros: flavorless; doesn't thicken liquid that it's mixed in, so it doesn't clog pumps and it can be added to formula and food. Cons: seems ineffective for many kids, especially those without a colon.
  • Metamucil - We found that for AustinRath Metamucil works much better for increasing stool thickness and decreasing outputs. We found about a 20% decrease in ostomy outputs with Metamucil and significant thickening of stool - from water consistency to yogurt consistency. Try putting 1/2 a teaspoon of Metamucil in an ounce of water and see how it thickens. At 24 lbs, we use a total of 3.5 tsp. of Metamucil per day, added to bottles and g-tube feeds at night. We tried just one afternoon on Metamucil for MaxMunakata and got scared off by how much it seemed to make him dump -- this is very limited data though. Pros: Thickens very effectively; no sugar; tastes good and makes a yummy 'icecream' if frozen. We make "icecream" by mixing 25 ml of heavy cream, 25 ml of formula and 1/2 tsp. of metamucil. Freeze and serve. Cons: Thickens liquid quickly, so you may end up spoon feeding the formula; can clog up feeding tubes/pumps if made too thick; some kids may not tolerate the taste (we found orange and berry flavor - not sure if there is a flavorless) and due to the flavor, it really can't be added to foods. Metamucil comes in both regular and sugar free - make sure you buy the sugar free variety. It's available to pharmacies over the counter.
  • Following the B.R.A.T Diet, a treatment for loose stool, can be helpful. Items in the diet include Banana, Rice, Apple Sauce and Toast.
  • Dairy may cause increased stool. However, we have found that heavy cream significantly thickens the stool (much better than Imodium or Benefiber). It also adds a lot of calories.
  • Some believe the any types of sugar, including those in fruit, can cause increased outputs. However, others believe that just processed sugars (cake, cookies, etc) should be avoided. Bananas and apples (no skin) are fruits that are most associated with potentially thickening stool.