Researchers looked at dozens of studies to find out which foods and supplements really help people with chronic constipation. They discovered that certain foods like prunes and kiwis, plus some supplements like psyllium and probiotics, have solid scientific proof they work. However, many doctors aren’t recommending these proven options, while some recommendations aren’t backed by strong evidence. This review shows there’s a gap between what science proves works and what doctors typically suggest, and suggests doctors should update their guidance based on the latest research.

The Quick Take

  • What they studied: Which foods, drinks, and supplements actually help people who have trouble with bowel movements on a regular basis
  • Who participated: This was a review of many different research studies involving thousands of people with chronic constipation, rather than a single study with one group of participants
  • Key finding: Seven dietary approaches have strong scientific evidence: psyllium powder, certain probiotics, magnesium supplements, kiwi fruit, prunes, rye bread, and mineral-rich water. Yet doctors often recommend fiber without specifying which kind, and sometimes suggest things without good evidence behind them.
  • What it means for you: If you struggle with constipation, you might want to talk to your doctor about trying proven options like prunes or kiwis before jumping to medications. However, everyone’s body is different, so what works for one person might not work for another.

The Research Details

This wasn’t a single experiment but rather a comprehensive review where researchers gathered and analyzed all the high-quality studies already done on constipation and diet. They looked specifically at randomized controlled trials, which are considered the gold standard in medical research because they compare one group getting a treatment to another group getting a placebo (fake treatment) to see what really works.

The researchers examined what clinical guidelines (the official recommendations doctors follow) actually suggest for constipation treatment. They compared these guidelines to what the scientific evidence actually shows works. This helped them identify gaps—places where doctors aren’t recommending things that research proves effective, or where doctors recommend things without strong scientific backing.

By reviewing all this existing research together, the scientists could see patterns about which dietary approaches have the most solid evidence behind them and which ones need more study.

This type of review is important because doctors need to know what actually works so they can give patients the best advice. When guidelines don’t match the evidence, patients might miss out on simple, natural solutions. This research helps bridge that gap and shows where doctors need to update their recommendations.

This review was published in a respected nutrition science journal and examined only high-quality research studies. The main limitation is that the review itself didn’t conduct new experiments—it analyzed existing studies, which means the quality depends on those earlier studies. The researchers were transparent about what evidence exists and what’s still unclear, which is a sign of good scientific work.

What the Results Show

The review identified seven dietary approaches with solid scientific evidence for helping with constipation: psyllium supplements (a type of fiber powder), specific probiotic supplements (beneficial bacteria), magnesium oxide supplements, kiwi fruit, prunes, rye bread, and water with high mineral content.

However, the researchers found a significant problem: most clinical guidelines only recommend a few of these options. The most commonly recommended approach is dietary fiber in general, followed by senna supplements and psyllium. This means doctors often suggest fiber without being specific about which type works best, even though the research shows some types work better than others.

Interestingly, some foods with strong evidence—like kiwis and prunes—are rarely mentioned in official guidelines. Meanwhile, some recommendations in guidelines aren’t well-supported by research. For example, guidelines often recommend insoluble fiber supplements, but the evidence for this specific type isn’t as strong as for other options.

The review also found that current guidelines often lack clear instructions about how to use these dietary approaches. For example, they might say ’eat more fiber’ without explaining how much, what type, or how quickly to increase it. This vagueness can make it hard for patients to actually follow the advice effectively. Additionally, the researchers noted that some dietary strategies that people commonly use—like Chinese herbal supplements—have very little scientific testing despite being recommended by some doctors.

This review updates and expands on previous research by looking at the most recent studies and comparing them directly to what doctors actually recommend. It shows that the gap between science and practice has grown as new research emerges. Previous reviews may not have highlighted this mismatch as clearly, making this work valuable for showing doctors where they need to catch up with the latest evidence.

The main limitation is that this is a review of other studies rather than new research. The quality of the conclusions depends on the quality of the original studies reviewed. Additionally, the review doesn’t provide a detailed analysis of why guidelines haven’t been updated—there may be practical or safety reasons doctors haven’t adopted some recommendations. The review also notes that some dietary approaches need more research to be truly confident about them.

The Bottom Line

If you have chronic constipation, consider discussing these evidence-backed options with your doctor: prunes or kiwi fruit (eat regularly as a snack), psyllium supplements (follow package directions), or specific probiotic supplements (though not all probiotics work equally). Start with food-based options first since they’re gentler and have fewer side effects. If those don’t work after 2-3 weeks, discuss supplements with your doctor. Confidence level: Moderate to High for prunes, kiwis, and psyllium; Moderate for probiotics and magnesium.

Anyone with chronic constipation should care about this research, especially people who want to try natural approaches before medications. People with certain health conditions (like kidney disease) should check with their doctor before using magnesium supplements. Pregnant women should also consult their doctor before trying new supplements. This research is less relevant for people with constipation caused by specific medical conditions that require medication.

Most dietary changes take 1-3 weeks to show effects. Prunes and kiwis typically work within a few days to a week. Psyllium usually shows results within 3-5 days. Probiotics may take 2-4 weeks to show benefits. If nothing improves after 3-4 weeks, talk to your doctor about other options.

Want to Apply This Research?

  • Log daily bowel movements (frequency and ease on a 1-10 scale) and track which foods or supplements you consumed. Note timing—how long after eating prunes or taking psyllium did you see results? This helps identify what works best for your body.
  • Set a daily reminder to eat one serving of prunes or a kiwi fruit at the same time each day. Use the app to track this habit for 3 weeks to see if it helps. You can also set reminders for drinking more water or taking psyllium supplements at consistent times.
  • Create a weekly summary view showing your bowel movement patterns and which dietary changes correlate with improvements. Over 4-8 weeks, you’ll see which approaches work best for you personally. Share this data with your doctor to make informed decisions about your constipation management.

This review summarizes scientific research on dietary approaches to constipation but is not medical advice. Chronic constipation can sometimes indicate underlying health conditions that need professional evaluation. Before starting any new supplement or making significant dietary changes, especially if you’re pregnant, nursing, taking medications, or have existing health conditions, consult with your doctor or registered dietitian. This information is for educational purposes and should not replace professional medical guidance.