An assessment of nutrition and physical activity guidelines for adult patients with chronic constipation: A systematic review

Abstract

Background and aim

To document and assess dietary and physical activity-based guidelines by expert committees for patients with chronic constipation.

Methods

A systematic review was performed using PubMed, CINAHL, PsychInfo, and Sage Journals databases. Inclusion criteria consisted of articles that documented guidelines on addressing chronic constipation among adults by expert committees during the last twenty years. This study excluded articles that focused on pediatric chronic constipation, short-term constipation or pharmacological guidelines, abstracts, conference proceedings, and articles not published in peer-reviewed journals.

Results

A total of 10 articles from different expert groups in Europe, Latin America, Mexico, the United Kingdom, and the United States were retrieved using the inclusion criteria. Behavioral modification with a gradual increase in dietary fiber was commonly agreed in eight consensuses. Four consensuses were specific in recommending a daily dose of 25–30 g of fiber to treat mild to moderate chronic constipation. Other dietary modifications included drinking water rich in minerals, especially magnesium. There was a lack of and/or discrepancies among the expert panels for recommending regular physical activity to relieve symptoms of chronic constipation.

Conclusions

A gradual increase in dietary fiber was the most cited nutritional advice. Guidelines for regular physical activity were low to moderate and at times conflicting. There is a need for future research to develop specific and evidence-based non-pharmacological guidelines to treat chronic constipation among adults.