For Constipation, New Dietary Guidelines Recommend Kiwis, Mineral Water, and Rye Bread
“Previous medical guidelines have offered only limited dietary recommendations, and these were often outdated,” says lead author Eirini Dimidi, PhD, a registered dietitian and nutritionist and a reader in nutritional sciences at King’s College London.
Through what Dr. Dimidi and her team describe as “a comprehensive assessment of existing research,” the new guidelines provide dietary recommendations “that have been shown to be effective in constipation — providing practical, clear, and effective choices to people with chronic constipation.”
A surprising finding was a lack of strong evidence for generic high-fiber diets, which clinicians commonly advise for constipation relief, Dimidi says.
Those recommendations are indeed vague, agrees Lisa Malter, MD, director of the inflammatory bowel disease program at Bellevue Hospital Center in New York City.
Guidelines Identified 59 Evidence-Based Remedies
The new guidelines, published jointly in the Journal of Human Nutrition & Dietetics and Neurogastroenterology & Motility, are based on four systematic reviews and meta-analyses focused on randomized controlled trials of dietary interventions for chronic constipation.
Randomized controlled trials are considered the gold-standard in scientific research, because they offer the strongest evidence that a given intervention causes an observed outcome.
The multidisciplinary research team — which included dietitians, a nutritionist, a gastroenterologist, a gut physiologist, and a general practitioner — identified a total of 59 interventions for constipation relief, including:
Kiwis
Rye Bread
High Mineral-Content Water
The guidelines suggest 0.5 to 1.5 liters (roughly 2 to 6 cups) per day may help improve constipation symptoms when used with other treatments. Mineral water often contains magnesium, which has known laxative properties.
Magnesium Oxide Supplements
The review found magnesium oxide supplements reduced bloating and abdominal discomfort for people with constipation. The authors recommend 0.5 to 1.5 grams (g) per day to reduce symptoms and improve stool frequency and consistency, starting with 0.5 g a day and gradually increasing the dose weekly.
Magnesium oxide works by pulling water into the intestines, “allowing for a smooth exit,” says Sue-Ellen Anderson-Haynes, RDN, a spokesperson for the Academy of Nutrition and Dietetics in Boston who was not involved in the study.
Fiber Supplements
Fiber supplements may help constipation by adding bulk to stool, according to Anderson-Haynes. For constipation relief, the review recommended taking at least 10 g per day of a fiber supplement like psyllium.
Probiotics
Some probiotic strains, including Bifidobacterium lactis and Bacillus coagulans UIS2, may help some people relieve constipation, but the study notes that there’s a “lack of convincing evidence to recommend specific strains of probiotics in constipation.” If you try one, researchers recommend following the product’s instructions for four weeks.
What Is Chronic Constipation and How Is It Treated?
“If these symptoms occur for more than three months, it meets criteria for chronic constipation,” says Rabia de Latour, MD, a gastroenterologist and director of endoscopy at NYC Health and Hospitals/Bellevue. Dr. de Latour did not contribute to the new guidelines.
“Patients with chronic constipation should be aware that if their symptoms are mild, they may be able to manage them independently with dietary changes and not have to suffer with symptoms or solely rely on medications to get relief,” Malter says.
How to Safely Use Supplements for Constipation Relief
Always talk to your healthcare team about any new supplement you may be interested in using to make sure it’s safe for you and won’t interact with any medications you may be taking.
Malter says anyone consuming high-fiber foods or supplements for constipation should drink plenty of water to avoid cramping, bloating, and excessive gas.
If you’re new to fiber supplements, start with a small dose and increase the amount gradually, and make sure to increase your fluid intake, too.
Magnesium-based supplements can elevate mineral levels in the blood, which could be dangerous for people with kidney disease or interact with certain medications, Malter says.
Anderson-Haynes suggests working with a gastroenterologist to identify the cause of your constipation and a registered dietitian to get relief through food. Taking these steps can help you prevent constipation in the future.
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