Consumption of more proteins and less fibre while battling COVID-19 can lead to constipation and discomforting complications such as anal fissures and bleeding, warn doctors who have come across a few such cases. Medical experts and nutritionists say less fibre leads to digestion issues and advise against relying on only one form of food. Instead, bringing about diversity in diet is a good idea.
Assistant professor of urology at Osmania General Hospital, S. Anand said three to four patients who have recovered from COVID have consulted him for constipation and anal fissures.
“They were post-COVID patients who relied on a low fibre, high protein diet for at least two meals during treatment. Their diet had less fibre. Protein from meat is completely absorbed by the body. So if someone has only protein and less fibre, it could lead to hard stools, causing painful defecation and fissures,” said Dr Anand.
He suggests a balanced diet that includes enough fibre, along with adequate consumption of water.
It was estimated that a few more patients might have suffered from constipation without serious complications, and relied on home remedies for relief. Dr Anand says there is a reason that vegetable salads are served at functions where people typically have rich food, since it contains fibre.
Clinical pharmacologist G. Srinivas says certain steroids and antibiotics increase appetite.
“When doctors prescribe more protein, they might not mean consumption of only protein. Other foods containing fibre, carbohydrates, antioxidants also have to be consumed,” he said.
Head of Critical Care at Government Medical College at Nizamabad, Kiran Madhala says the most common side-effect of any drug are gastrointestinal disturbances such as diarrhoea and acidity. To counter acidity, doctors usually prescribe antacids. One has to be particular about when medicines are advised to be taken — whether on empty stomach or after food, he adds.
National Institute of Nutrition director R. Hemalatha also agrees that a high-protein, low-fibre diet can cause constipation. Prolonged intake of high protein may result in digestion problems, renal stone formation and vascular abnormalities. “Dietary proteins provide amino acids for the synthesis of body proteins, including enzymes and hormones. As per our recently published Recommended Dietary Allowances, an adult requires 0.66 g protein/kg body weight/day; and on the higher side not more than 1g protein/kg/day is required for all functions in the body, including immune response, synthesis of new proteins and replacement of those that are broken down. High protein diets that provide more than 15% energy (calorie) from protein, is not routinely advocated,” Dr Hemalatha adds.
Fibre-rich food
So which foods are rich in fibre? Nutritionist Aparna Nemalikanti names green leafy vegetables, fruits, salads, sprouts and legumes.
“The recommended fibre intake for an adult is 30 g/day, which can be obtained through wholegrain cereals or millets, pulses, beans, fruits and vegetable. Adequate fibre intake prevents constipation and also prevents cardiovascular diseases, diabetes, colon cancer and reduces the risk of hyperlipidemia, hypercholesterolemia and hyperglycemia,” suggests Dr Hemalatha.
