Chronic Constipation: Is a Nutritional Approach Reasonable?

Abstract

Chronic constipation (CC) is one of the most common gastroenterological diagnoses in clinical practice. Treatment includes several steps, depending on the severity of symptoms. Lifestyle modifications and increased intake of fiber and water are suggested by most health professionals. Unfortunately, the recommendations in this regard are the most varied, often conflicting with each other and not always based on solid scientific arguments. This paper aims to clarify this topic by providing practical indications for the management of these patients in every day clinical practice. The literature available on this topic is scarce, and dietary studies have important methodological biases. However, fiber, mainly by binding water and acting as bulking agents and/or as prebiotics for the intestinal microbiota, and mineral water, especially if rich in magnesium and/or bicarbonate, are useful tools. An adequate, well-designed diet should be a cornerstone of any effective treatment for chronic constipation. High-quality studies on larger samples are mandatory to give scientific validity to the role of the food in CC therapy and to enable professionals to choose the best approach for their patients, combining nutritional and pharmacological agents.

Association of Dietary Energy Intake With Constipation Among Men and Women: Results From the National Health and Nutrition Examination Survey

“…Therefore, in routine clinical practice, dietary management is usually considered the cornerstone of any treatment for chronic constipation. Finite sample size and methods restrict the exploration of complex mechanisms linked to all kinds of foods, so current research mainly focuses on a small part of food ingredients, such as fiber and mineral water ( 5 ). Previous studies have confirmed that intake of low liquid, high dietary saturated fat would increase the constipation risk, while intake of soluble fiber, such as Guar gum and Psyllium, and microelements, such as selenium and magnesium, would impose a converse effect ( 6 – 9 ).…”

Neuroendocrine Tumors: A Comprehensive Review on Nutritional Approaches

“…KD should be used with caution, based on studies that report an increased risk of constipation in patients using this nutritional pattern, especially those over 70 years of age [ 138 ]. Finally, general indications suggested not to skip meals [ 139 ]; in this context, IF regimen should be avoided.…”

Cannabis sativa L. alleviates loperamide-induced constipation by modulating the composition of gut microbiota in mice

“…Constipation, characterized by dry stools, prolonged defecation cycle, and defection difficulty, is one of the most common gastrointestinal disorders diagnosed in clinical practice, with a prevalence of 12%-19% worldwide (Bellini et al, 2021;Włodarczyk et al, 2021). Constipation decreases quality of life as patients often suffer from both physical symptoms and psychological distress (Włodarczyk et al, 2021).…”