This is why so many women are suffering from constipation – and EXACTLY how to relieve the agony: DR EMILY LEEMING

Keeping ‘regular’ might have been something your granny talked about, but it’s a common problem for a surprisingly large number of us. Around one in seven of us suffer regularly with constipation, according to a major review of studies in the American Journal of Gastroenterology.

It’s twice as common in women than men – due to a number of reasons, including women have slightly longer colons (so things simply take longer to move through); fluctuations in sex hormones that can slow the gut down and changes to the pelvic floor following pregnancy.

While constipation is common and often harmless, a persistent change in your usual bowel habits (especially if it comes with blood in your poo, unexplained weight loss, or ongoing tummy pain) can be a sign of something more serious.

That’s why it’s important to pay attention and get checked if you notice changes that don’t go away after about three weeks.

But most of the time, constipation isn’t a sign of something sinister – and there are plenty of safe, science-backed ways to get things moving again.

Not quick-fix detox teas or miracle supplements – which at best do nothing, and at worst can leave you more dehydrated – but practical strategies that actually work. Here are seven I regularly recommend – with a few that may surprise you.

Most of the time, constipation isn’t a sign of something sinister – and there are plenty of safe, science-backed ways to get things moving again, writes Dr Emily Leeming

Eat more kiwi – and the skin

If I had to pick one fruit for constipation, it would be the kiwi. A 2023 study in the American Journal of Gastroenterology found that eating two kiwi a day (without the skin) significantly improved constipation and gut comfort – sometimes outperforming psyllium husk (a type of fibre made from the husks of Plantago ovata seeds and the gold-standard fibre supplement for constipation, see below).

In the study, both provided the same amount of fibre (about 6g – from two kiwis, or 7.5g of psyllium husk- your recommended daily intake of fibre is around 30g). But kiwi delivered broader benefits, such as powerful plant compounds known as polyphenols, the enzyme actinidin (which helps speed up the digestion of protein, moving things along faster), as well as the fruit’s high water content, which helps speed things along by softening the poo.

Even better, eat it with the skin on – a kiwi has about 2-3g of fibre in the flesh, but with the skin you’ll get roughly 50 per cent more.

Use a footstool

Placing a small footstool in front of your loo can make going much easier.

The reason is anatomical – when your feet are raised, your knees come above your hips, which straightens the angle between the rectum and anus and makes it easier for stool to pass. You don’t need any specialist kit, a low step, yoga block or even a sturdy box will do.

And it works: when healthy adults were tracked over 1,100 bowel movements, using a footstool meant they were 3.6 times more likely to feel fully emptied; it also reduced straining by 77 per cent, reported the Journal of Clinical Gastroenterology in 2019.

Enjoy a cup – or three – of coffee

Feel the urge to go after your morning coffee? That’s because caffeine stimulates the gastrocolic reflex, the natural wave of movement in your gut that happens after eating or drinking.

A 2024 study published in BMC Public Health found that adults who drank the equivalent of one strong cup of coffee a day had around a 40 per cent lower risk of constipation, compared with people who barely touched caffeine. Having two or three cups a day cut the odds by a third.

Rub your tummy

A 2024 review in Neurogastroenterology & Motility found that yoga helps with symptoms of a number of digestive disorders – especially IBS, where constipation is often a symptom. The stretches and twists in yoga may gently stimulate the gut, while the relaxing effect calms stress pathways that can tighten abdominal muscles and slow things down.

If yoga isn’t your thing, abdominal massage may offer similar benefits – the secret is to do it clockwise, following the natural path food takes through the colon.

Lie on your back with your knees bent and feet flat on the floor. Gently massage your belly in slow circles, moving clockwise from the right side of your abdomen, across the top, then down the left side. Do this once or twice a day for ten minutes at a time.

Your gut has a natural rhythm, and the colon is most active after you wake up, writes Dr Leeming

Try turbo-charged fibre

While ‘eat more fibre’ is obvious advice for constipation, the type and amount matters, according to a 2022 review of studies, published in The American Journal of Clinical Nutrition.

Psyllium husk, which helps soften and bulk out poo, making it easier to pass, stood out as the most reliable option. The research showed that people needed more than 10g of psyllium husk a day (you can buy as a supplement or powder from most pharmacies) for at least four weeks before the full benefits showed.

But start low (1tsp mixed into at least 250ml water) and increase slowly to let your gut adjust. Make sure you drink a full glass of water with it each time, and stay hydrated through the day, as psyllium absorbs water and can cause you to become more bunged up if taken with too little liquid.

Go to the loo first thing

Your gut has a natural rhythm, and the colon is most active after you wake up. Part of that is down to gravity – after lying flat overnight, standing up helps shift things along. Then breakfast gives an extra push, thanks to the gastrocolic reflex. Together, these cues make the morning the best time to go.

Building a habit of going at the same time each day (even if you don’t feel a strong urge) can help ‘train’ your bowels to be more regular, because your body learns to expect it and starts sending stronger signals over time. Give yourself ten minutes of relaxed, unhurried time – ideally after breakfast, to get your body used to a daily rhythm.

Are you really drinking enough?

This might seem too obvious to say, but drinking enough really matters: dehydration is a surprisingly common cause of sluggish bowels. Fibre needs water to do its job properly – without it, stools can become dry and more difficult to pass.

A 2020 study in the Journal of the American College of Nutrition found that people who drank the least water had about a 30 per cent higher risk of constipation than those who drank more. Aim for around eight glasses – which includes tea, coffee and water. Pale yellow urine is a good sign you’re well-hydrated.

ASK EMILY

Q The past couple of blood tests I’ve had have shown I’m very low in potassium. I’ve been put on spironolactone, but it gives me diarrhoea. What can I eat to help with potassium deficiency – and would a supplement be a good idea?

A It’s important to let your healthcare team know about diarrhoea, as this itself can lower potassium levels.

Potassium is an essential electrolyte, which helps regulate a number of key functions, including muscle contractions and heartbeat.

In your longer letter you say you were on indapamide, a type of water tablet used for blood pressure. This can also cause your body to lose potassium, which is why you were switched to spironolactone, another water tablet but one that works differently and helps the body retain potassium.

The trade-off is that spironolactone can sometimes upset the stomach. It can also raise potassium too high, so potassium supplements are rarely recommended unless prescribed. Your healthcare team can decide if you need these.

In the meantime, the focus should be on potassium-rich foods, such as fruit (bananas, oranges, kiwis, apricots and prunes) and vegetables (including spinach, kale, broccoli, sweet potatoes, mushrooms and tomatoes). One baked potato, for example, provides 841 mg potassium; a banana has about 422 mg.

Nuts, seeds, beans and oily fish such as salmon or mackerel are also good sources.

If you have a question for Emily, send it to dremily@dailymail.co.uk or write to Good Health, Daily Mail, 9 Derry Street, London, W8 5HY. Replies should be taken in a general context; consult your GP with health concerns.

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