When it comes to the best foods to relieve chronic constipation, are kiwis on your grocery list?
New dietary guidelines from the British Dietetic Association, published on Monday, say kiwifruit – along with rye bread and some supplements – can help improve symptoms of constipation.
According to the authors, these guidelines are the first evidence-based recommendations for treating constipation with diet and not medication.
Chronic constipation affects approximately 16% of adults worldwide and accounts for nearly 2.5 million doctor visits in the United States per year, according to the American College of Gastroenterology.
Eirini Dimidi, one of the lead authors of the guidelines, said existing guidelines for managing chronic constipation are largely focused on pharmaceuticals.
The few dietary recommendations that exist – eat more fiber, drink more water – are ambiguous and often lack research to support them.
“I remember looking at the guidelines and realizing that they were really limited in the number of dietary recommendations they made,” said Dimidi, a dietitian and associate professor in the department of nutritional sciences at King’s College London.
To come up with these new guidelines, the authors analyzed clinical trials and evaluated the effectiveness of each method for managing constipation. The recommendations were published jointly in the Journal of Human Nutrition & Dietetics and Neurogastroenterology & Motility.
What is chronic constipation?
Constipation – defined as fewer than three bowel movements per week – is considered chronic if it lasts more than three months.
Symptoms may vary from person to person, but the most common are hard or lumpy stools, stomach upset, and nausea. More serious symptoms of constipation include blood in the stool, fever and vomiting.
Constipation can be caused by diet, lifestyle, certain illnesses and injuries, and certain medications. It is extremely common and affects people of all ages, genders and races.
“I see chronic constipation across the board,” said Sue-Ellen Anderson-Haynes, a registered dietitian and spokesperson for the Academy of Nutrition and Dietetics. “I see it in toddlers, I see it in school-aged children, I see it in adults. So it’s a common thing,” she said.
Chronic constipation can have serious consequences on people’s lives and limit their physical abilities, thus degrading their quality of life and their productivity at work.
“If you have chronic constipation, you may not even be able to participate in physical activity because you feel bloated, you’re sore, you’re sore, it can affect your mood,” said Anderson-Haynes, who also owns 360 Girls and Women, a Boston-based nutrition and health practice.
How is chronic constipation treated?
Dr. William Chey, a professor of gastroenterology at the University of Michigan and the new president of the American College of Gastroenterology, said most studies on treating chronic constipation have focused on fiber supplements, such as psyllium, and medications, such as bisacodyl, senna and amitiza.
He added that the U.S. guidelines “focus quite heavily on medical therapies for chronic constipation.”
Traditional treatments for constipation include increasing fiber intake through foods like prunes and other fruits and vegetables, drinking more water, and using different types of laxatives.
Although the new guidelines include some high-fiber foods and fiber supplements, there are no overarching guidelines for a “high-fiber diet.”
“When we developed these guidelines and looked at the literature, we expected a lot more evidence on a high-fiber diet, and there just isn’t enough in the case of constipation,” Dimidi said.
“There is plenty of evidence that a high-fiber diet is very beneficial for our overall health as well as certain elements of gut health, such as reducing the risk of colorectal cancer,” she added. “But when it comes to constipation in particular, we just don’t have enough evidence to say that it improves constipation.”
What are the new recommendations?
Chey, who was not involved in the new guidelines, said the recommendations “provide a valuable road map for things that [people] can try while waiting to see their primary care physician.
He added that people with more severe constipation may need to see a gastroenterologist.
Recommendations include:
- Fiber supplements: More than 10 grams of fiber supplements, such as psyllium, per day can improve stool frequency and consistency and help reduce straining. Fiber supplements should be introduced slowly and the dosage increased gradually.
- Probiotics: Certain strains of probiotics, including: B. milk And Bacillus coagulans IS2 unique, may help some people with symptoms. If taking one, patients should take a supplement of their choice and follow the manufacturer’s instructions for at least four weeks.
- Magnesium oxide supplements: 0.5 to 1.5 grams per day may help reduce the frequency and consistency of stools, reduce symptoms such as bloating and abdominal pain, and improve overall quality of life. The dosage should start at 0.5 grams per day and be gradually increased every week.
- Kiwis: Three per day, with or without the skin, may help improve stool frequency but not consistency.
- Rye bread: Six to eight slices of rye bread a day may also improve bowel movement frequency, but not consistency. The authors noted that this amount might not be realistic for some people.
- High-mineral water: In combination with other treatments, 0.5 to 1.5 liters per day of high-mineral water can also help. One of the key minerals in high-mineral water, magnesium, is a known laxative.
The only recommendation that gives Chey pause is probiotics. “People’s microbiomes… vary a lot from place to place based on diet, genetics, environment, and so it’s very difficult to make generalizable statements about the use of specific probiotics,” he said.
Still, overall, he said, “I think these kinds of recommendations are going to be very helpful.” »
Dimidi said she hopes the release of the guidelines can “empower” people with chronic constipation.
“We hope [the guidance] This means that clinicians are very well informed and can provide their patients with very effective personalized advice,” she said. “But also that people themselves suffering from constipation can now access evidence-based information, feel empowered to take control of their symptoms and improve a condition that has a huge impact on quality of life.”
