Fiber Intake and Colorectal Cancer—Reply

In Reply We thank Kurokawa and colleagues for their interest in our recent publication. In clinical practice, our experience suggests that bowel obstruction attributable to a high-fiber diet is rare—certainly well below the 13% cited by the authors in the 2 case reports. We also suggest that bowel obstruction due to dietary components would most likely require an unusually excessive intake of high-fiber food—well beyond the range of intake within the highest quartile group in our study (median = 29 g/d). Finally, most bowel obstructions require a predisposing anatomic factor, which would most likely manifest among patients with colorectal cancer in the immediate postoperative period. In our study, we assessed fiber intake at least 6 months after surgery.

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