Adverse effects also shared with dietary fibre in- clude bloating and flatulence which may discourage the older patient from continuing with them. However, these symptoms tend to resolve in the second week of treat- ment,16so the patient should be encouraged to persist. Temporarily reducing the dose may also be helpful. Bulk laxatives do not cause malabsorption of iron (unlike un- processed bran),fat-soluble vitamins or digoxin