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Small-Bowel Obstruction From Bran Cereal

Daniel L. Miller, MD; Pamela F. Miller, RD, CDE; Jan J. Dekker, MD, PhD
JAMA. 1990;263(6):813-814. doi:10.1001/jama.1990.03440060053027.
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To the Editor.—  During the past decade, a diet high in fiber has been recommended in the prevention and/or treatment of diabetes, colon cancer, heart disease, irritable bowel disease, diverticular disease, hypercholesterolemia, and constipation.1,2 Today, concentrated dietary fiber (ie, whole-grain cereals) is the most commonly used source of fiber in the United States.3 However, use of concentrated fiber has not been without complications. Cases of diarrhea and small-bowel obstruction have been reported.4,5 Recently, we treated a 34-year-old man for small-bowel obstruction caused by a bran cereal bezoar.

Report of a Case.—  The patient was instructed by his physician to eat a large bowl of bran cereal, approximately 20 g/d, for constipation. After 10 days of eating the bran cereal, he developed periumbilical pain, nausea, vomiting, and fever. His medical history revealed only that he had a 2-year history of hypertension that required daily diuretic therapy. The patient

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