New Clinical Guidelines Offer evidence-Based Dietary Approaches for Constipation Management
Recent clinical guidelines,jointly published in the Journal of Human Nutrition & dietetics and Neurogastroenterology & Motility,aim to modernize the treatment of chronic constipation. Developed with the support of the British Dietetic Association (BDA), the guidelines seek to equip doctors, nurses, and dieticians with updated recommendations for clinical practice, and empower patients to better manage their symptoms, particularly through dietary adjustments.
Constipation is a widespread condition that significantly impacts quality of life and places a significant financial burden on healthcare systems. Previous clinical guidance often provided limited and sometimes outdated dietary advice, primarily focusing on increased fiber and fluid intake.
These new recommendations represent a shift, being grounded in numerous rigorous systematic reviews and meta-analyses assessed using the GRADE framework for evaluating evidence quality. A multidisciplinary expert panel – including dietitians, a nutritionist, a gastroenterologist, an intestinal physiologist, and a general practitioner – meticulously reviewed over 75 clinical trials, resulting in 59 suggestion statements and the identification of 12 key areas for future research.
Eirini Dimidi, Senior Lecturer in Nutritional Sciences at King’s College London and lead author of the guidelines, emphasizes the impact of the new approach: “Chronic constipation can have a big impact. For the first time, we have provided guidance on wich dietary approaches can really help and which lack evidence.”
The guidelines prioritize constipation-related outcomes like stool frequency, consistency, straining during bowel movements, and overall quality of life, allowing for more personalized care. However, the evidence review also revealed a critical need for improved research quality in this area.Existing studies often focused on isolated interventions rather than extensive dietary strategies.
While a high-fiber diet is generally beneficial for overall health, the guidelines found insufficient evidence to specifically support its effectiveness for constipation. Dimidi notes, ”Eating a high-fiber diet offers many benefits to overall health and has been a common recommendation for constipation. Though, our guidelines found that there is simply not enough evidence to support its specific effectiveness for constipation. Instead,our research reveals new dietary strategies that coudl help patients.”
Kevin Whelan highlights the potential of these guidelines to improve patient care, stating that they represent “a promising step towards empowering healthcare professionals and their patients to manage constipation through diet,” and that they will allow individuals worldwide to “receive up-to-date advice based on the best available evidence to improve their symptoms and well-being.” He further emphasizes the importance of continued research to solidify understanding and achieve lasting improvements in quality of life.
