Whether we’re comfortable talking about it or not, I reckon most of us feel better for having a good dump each day. A diet rich in fibre is generally taken as a core component of bowel regularity, and drinking plenty of water is often recommended to help ensure fluid function in this department too. However, conventional wisdom regarding what it takes to ensure healthy bowel action seemed to get flushed down the pan earlier this year on the publication of a review in the American Journal of Gastroenterology entitled ‘Myths and Misconceptions About Chronic Constipation’. In it, an international triumvirate of doctors downplayed the importance of fibre and fluid in maintaining colonic consistency, and instead gave enthusiastic support for the use of laxatives.

Before buying into another pill for an ill approach so prevalent in modern medicine, I thought I would take a detailed look at the study in question to get the full inside story. While its authors appear to have little faith in the value of fibre in maintaining bowel regularity, they at the same time cite a study in which fibre supplementation partially or completely resolved the symptoms of 80 per cent of individuals with constipation of no identifiable cause (the majority of constipation cases). Yet, while additional fibre can indeed help ensure regular bowel action, the form that the fibre comes in can have a bearing on its effects on the gut.

Studies suggest that what is known as insoluble fibre (found, for instance, in bran-based breakfast cereals) often tends to worsen bowel symptoms. Research has found that so called ‘soluble fibre’, found in foods such as oats, fruit, vegetables, beans and lentils, may assist bowel function and is generally better tolerated. In practice, increasing intake of foods rich in soluble fibre can often help to keep waste matter moving. In one study, the addition of kiwi fruit to the diet (one kiwi fruit for every 30 kg of body weight each day) improved both stool frequency and consistency.

One simple way to add weight to our waste is to supplement with linseeds (also known as flaxseeds). These contain a good amount of soluble fibre, along with omega-3 fats that are believed to help maintain health in the lining of the gut. I generally recommend having 1 - 2 dessertspoons of ground linseeds per day. These can be added to food, or just glugged down with some water. Any additional fluid will help hydrate the body and reduces the risk that the colon will sucking our faecal matter so dry that it ends up getting stuck in the gut, a bit like a cork in the neck of a wine bottle.

while the authors of the American Journal of Gastroenterology study were cool about the benefits of water, they quoted a study which found that drinking two litres of mineral water each day improved bowel frequency and reduced laxative use to a meaningful degree. This study mirrors my experience in practice, though I find it can take a week or two before increased fluid consumption has its full effect. Contrary to what some may have us believe, a diet rich in fibre and fluid does indeed have the capacity to leave us with an empty feeling inside.

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