Eating kiwifruits could help ease chronic constipation better than some laxatives, research suggests. A panel of nutritionists, dieticians and doctors led by King's College London (KCL) reviewed evidence from more than 75 trials.
They found that kiwifruits, rye bread and high mineral content water could all help alleviate symptoms of chronic constipation in adults. Psyllium fibre supplements, certain probiotic strains and magnesium oxide supplements were also found to help. However, the researchers found a lack of strong evidence for widely recommended approaches including generic high-fibre diets and senna supplements.
Lead author Dr Eirini Dimidi, reader in nutritional sciences at KCL, said: "Chronic constipation can have a huge impact on someone's day-to-day life.
"For the first time, we've provided direction on what dietary approaches could genuinely help, and which diet advice lacks evidence.
"Being able to improve this condition through dietary changes would allow people to self-manage their symptoms more and, hopefully, improve their quality of life."
The panel made 59 recommendations, including that patients may be advised to eat two to three kiwifruits per day for four weeks to treat constipation.
Experts suggested eating the fruits without the skin as the skin can provide additional fire, which could increase side effects. Kiwis are available from supermarkets including Tesco for as little as 20p (£1.19 for a pack of six).
Patients could also be advised to eat six to eight slices of rye bread per day for at least three weeks, the guidelines said. However, they noted this "may not be realistic or manageable for some patients".
Dr Dimidi added: "Eating a high fibre diet offers many benefits to overall health and has been a go-to recommendation for constipation.
"However, our guidelines found that there simply isn't enough evidence to suggest it actually works in constipation specifically.
"Instead, our research reveals some new dietary strategies that could indeed help patients. At the same time, we urgently need more high-quality trials to strengthen the evidence on what works and what doesn't."
The findings were published in two international journals, the Journal of Human Nutrition & Dietetics and Neurogastroenterology & Motility.
Dr Yvonne Jeanes, head of research and impact at the British Dietetic Association, said: "These guidelines are an excellent resource for dietitians and healthcare professionals more broadly, they support a more diet focused and evidenced-based approach to the management of chronic constipation."
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