New Guidelines for Chronic Constipation: A Shift Away from High-Fibre Diets

Chronic constipation affects millions of people worldwide, with various treatment options available. The British Dietetic Association has released new guidelines that advocate for a more personalized approach to managing the condition, with a focus on specific foods and supplements rather than high-fibre diets. The guidelines are based on a comprehensive review of 75 clinical trials, which have yielded 59 recommendations for food, drink, and supplements. While kiwifruit has received significant attention, mineral water and magnesium supplements are also recommended to help alleviate constipation.

Key Takeaways:

• The guidelines recommend eating two to three kiwifruit a day for at least four weeks to improve constipation. Kiwifruit contains fibre, enzymes, and crystals that help soften and lubricate stool, making it easier to pass.
• Mineral water can help relieve constipation by containing magnesium, which acts as a laxative. Drinking 0.5--1.5 litres a day for two to six weeks can be beneficial.
• Magnesium supplements can also help soften stool and increase frequency. However, individuals with kidney disease should be cautious, as excessive magnesium consumption can exacerbate the condition.
• Rye bread relieves constipation more effectively than white bread or common laxatives, but individuals with coeliac disease should avoid it.
• The guidelines suggest supplementing the diet with at least 10g of fibre per day, rather than relying on a high-fibre diet.
• Personalized dietary advice tailored to patient symptoms is a key aspect of the guidelines, emphasizing the importance of considering individual needs and health status.

Statistics:

• 75 clinical trials were reviewed to inform the guidelines.
• 59 recommendations were produced for food, drink, and supplements to manage chronic constipation.
• 25--30g of fibre per day was confirmed as a high-fibre diet in the only trial comparing high and low-fibre diets.
• Individuals on the low-fibre diet (15--20g/day) reported fewer farts and less bloating compared to those on the high-fibre diet.

Sources:

• The Conversation (Au and NZ) -- By Vincent Ho, Associate Professor and Clinical Academic Gastroenterologist, Western Sydney University
• The British Dietetic Association's guidelines