Eating a few kiwis a day may help relieve constipation and is a better starting point than worrying about a high-fiber diet, according to new guidance for doctors on the condition.
The advice says drinking water high in minerals is better for constipation than tap water, and magnesium oxide supplements help relieve symptoms.
Researchers from King's College London, who produced the guidelines after reviewing all the available evidence, said there was much more to be done than the standard advice to “just have more fiber in your diet.”
Constipation that does not go away affects one in ten people and can seriously affect the quality of life.
According to the NHS, you are constipated if you have not had a bowel movement (stool) at least three times in the last week or go to the toilet less often than usual.
Straining on the toilet or feeling like you haven't completely emptied your bowels can also be signs of constipation, but they aren't the only signs.
“People may report 30 different symptoms of constipation,” says Dr Eirini Dimidi, lead author of the study and lecturer in dietetics at King's College London (KCL).
The new guidance suggests the best remedy is to focus on fruits and drinks first, rather than worrying about the latest probiotics at the supermarket or filling your diet with different types of fibre, she says.
Dr. Dimidi recommends eating two to three kiwis during the day or 8-10 prunes to relieve constipation.
Kiwi with or without skin?
“Even without the skin, it’s good and contains fiber,” she explains, but adds that keeping the skin on doesn’t hurt either.
Kiwi fiber affects the intestines by increasing stool bulk, which can also cause intestinal contractions.
“Kiwi also increases water content in the intestines, which can soften stools,” says Dr. Dimidi.
Snacking on 8-10 prunes a day and a small amount of rye bread can also have a similar effect.
She said mineral water was “better to drink than tap water”, although bottled water in the UK contains fewer minerals than water available in other places, such as Eastern Europe.
The most important mineral is magnesium, which has a laxative effect. This is why, according to research, taking magnesium oxide supplements has many benefits.
These include reduction in lower abdominal pain, bloating, tension, and easier bowel movements.
When it comes to probiotics, recommendations say that certain types may help relieve some symptoms, but there is also a lack of research on the effects of many different strains of probiotics.
Until now, recommendations for doctors treating patients with constipation have been limited and outdated, focusing on increasing dietary fiber and water intake, the researchers say.
The new recommendations are based on data from 75 clinical trials (all available), which were analyzed by a panel of experts.
Professor Kevin Whelan, senior author of the studies and professor of dietetics at KCL, said the new guidance “marks a promising step towards enhancing the ability of healthcare professionals and their patients to manage constipation through diet.”
He says this means people with constipation can now access up-to-date advice to help improve their symptoms, wellbeing and quality of life.
The British Dietetic Association, which funded the project to develop the new guidelines, said they were an excellent resource for dietitians, doctors and nurses, and supported “a more diet-focused and evidence-based approach to the treatment of chronic constipation.”
The study and new recommendations were published in the journal Human Nutrition & Dietetics.
