How to manage constipation with dietary changes?

From the Guidelines

To manage constipation with dietary changes, increase fiber intake to 25-30 grams daily through foods like whole grains, fruits, vegetables, legumes, and nuts, and drink at least 8 glasses of water daily, as hydration is essential for softening stool. This approach is supported by the most recent and highest quality study 1, which emphasizes the importance of a varied and balanced diet, rich in fiber, for maintaining gut health and preventing constipation. Regular physical activity also helps stimulate bowel movements, and considering adding natural stool softeners like ground flaxseeds or prune juice can be beneficial. Gradually increasing fiber intake and establishing a daily routine of eating meals at consistent times and responding promptly to bowel urges can help establish regular patterns.

Some key points to consider when making dietary changes for constipation management include:

• Increasing fiber intake through foods like whole grains, fruits, and vegetables
• Drinking at least 8 glasses of water daily for hydration
• Limiting processed foods and added sugars, which can negatively impact gut health
• Considering the use of probiotic and prebiotic foods, such as yogurt, kefir, and fermented vegetables, to support beneficial gut bacteria
• Avoiding excessive intake of lactose, fructose, sorbitol, caffeine, and alcohol, which can exacerbate constipation symptoms

It's also important to note that while some studies suggest that a low-FODMAP diet may be beneficial for managing irritable bowel syndrome (IBS) symptoms, including constipation 1, the evidence for this approach is not as strong as the evidence supporting increased fiber intake and hydration. Therefore, increasing fiber intake and drinking plenty of water should be the primary dietary approach for managing constipation, with other dietary changes considered on an individual basis. If dietary changes do not provide relief within 1-2 weeks, over-the-counter options like docusate sodium or polyethylene glycol may be considered, as supported by earlier studies 1.

From the FDA Drug Label

Directions Put one dose into an empty glass. Mix this product (child or adult dose) with at least 8 ounces (a full glass) of water or other fluid. As your body adjusts to increased fiber intake, you may experience changes in bowel habits or minor bloating. New Users:Start with 1 dose per day; gradually increase to 3 doses per day as necessary. To manage constipation with dietary changes, the key points are:

• Increase fluid intake: mix the product with at least 8 ounces of water or other fluid
• Increase fiber intake: start with 1 dose per day and gradually increase to 3 doses per day as necessary
• Gradual adjustment: allow your body to adjust to the increased fiber intake to minimize changes in bowel habits or minor bloating 2

From the Research

Dietary Changes for Managing Constipation

To manage constipation through dietary changes, several options can be considered:

• Increasing dietary fiber intake, particularly with soluble fibers like psyllium, as they can help improve symptoms of constipation without worsening digestive symptoms like bloating and distension 3, 4, 5, 6.
• Ensuring adequate water intake, as it can enhance the effect of a high-fiber diet on stool frequency and laxative consumption 7.
• Gradually increasing fiber intake over several weeks to decrease adverse effects 4.
• Considering the type of fiber, as nonfermented gel-forming psyllium is more effective than insoluble wheat bran for increasing stool output in patients with chronic idiopathic constipation 6.

Foods and Supplements

Specific foods and supplements that may be beneficial for managing constipation include:

• Psyllium, which can be taken as a supplement to increase stool output and soften stools 3, 4, 5, 6.
• Polyethylene glycol (PEG), or macrogol, which can help increase the volume of intestinal contents, reduce consistency, and facilitate transport and evacuation 3, 4, 5.
• Polycarbophil, methylcellulose, which may improve symptoms of constipation 4, 5.
• A high-fiber diet with adequate fluid intake, which can increase stool frequency and decrease laxative use 7.

Important Considerations

When making dietary changes to manage constipation, it is essential to:

• Avoid high amounts of insoluble vegetable fiber, which can worsen digestive symptoms 3.
• Be aware that not all fibers are created equal, and some may not provide a laxative effect or may even be constipating 6.
• Monitor and adjust fluid intake, as adequate hydration is crucial for the effectiveness of dietary changes 7.