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Patients with kidney disease, heart failure, or other conditions requiring fluid restriction should follow their healthcare provider's guidance Distribution throughout the day : Spreading fiber across meals rather than concentrating intake at one time Individual tolerance : Some patients may temporarily require slightly lower fiber intake during initial treatment phases Patients experiencing persistent constipation despite adequate fiber and hydration should consult their healthcare provider, as additional interventions such as polyethylene glycol (PEG) or other osmotic laxatives may be appropriate per American Gastroenterological Association guidelines

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The cause of gluten sensitivity is not known