REVIEW article
Front. Pharmacol.
Sec. Gastrointestinal and Hepatic Pharmacology
This article is part of the Research TopicNew Insights into the Management of Chronic Idiopathic Constipation: From Physiopathology to Novel Therapeutic StrategiesView all 8 articles
Dietary strategies for chronic constipation: smartly targeting hormonal and reflex pathways for optimal recovery
Provisionally accepted
- Department of Translational and Precision Medicine, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Chronic constipation (CC) is a common disorder of gut-brain interaction that markedly impairs quality of life and remains challenging to manage. Despite the availability of laxatives and prosecretory agents, up to half of patients experience suboptimal relief, underscoring the need for complementary, physiology-based nutritional strategies. Nutrients influence intestinal motility through multiple pathways, including enteroendocrine signalling, bile-acid metabolism, microbiota-derived metabolites, and intestinal taste-receptor activation. Integrating these mechanisms into clinical nutrition requires structured approaches that align fiber type, bile flow, microbial modulation, and sensory stimulation with motility phenotype and fermentation tolerance. Among dietary interventions, the most consistent clinical evidence supports the use of soluble fiber (e.g., psyllium), kiwifruit or prunes, and magnesium-or sulfate-rich mineral waters to improve stool frequency and consistency. Other components, such as fermented foods, probiotics, and generic hydration, show variable efficacy and remain supported primarily by physiological or translational data. The SMART (Sensory, Motor, bile Acid and Reflex Tailored) Constipation Diet,is proposed as a hypothesis-generating dietary framework that integrates fiber optimization, bile stimulation, microbial support, and chrono-nutritional timing into a coherent dietary model. Given the heterogeneity of CC (e.g., functional constipation, IBS-C, defecatory disorders) and the scarcity of phenotype-stratified trials, the SCD should be regarded as a translational concept rather than a validated clinical protocol. Future randomized, controlled studies with hard motility and symptom outcomes are needed to determine whether coordinated, multi-pathway dietary modulation can outperform single-component interventions and advance precision nutrition in CC.
Keywords: Chronic constipation, chrono-nutritional timing, enteroendocrine signalling, Gastrocolic reflex, gut brain axis, personalized nutrition
Received: 03 Nov 2025; Accepted: 27 Jan 2026.
Copyright: © 2026 RIBICHINI, Scalese, Mocci, De Amicis and Severi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: EMANUELA RIBICHINI
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.