One in four Australians (that’s more than six million people!) are affected by constipation. With many different causes and types of constipation now identified, managing this uncomfortable condition is more complex than we once thought. No longer is the remedy just increasing fibre and fluid intake and doing more exercise, science is now discovering how pre- and pro-biotics can play a role in getting bowels moving. In this podcast, dietitian Sandra Mikhail explains how she ‘makes poo talk sound chic’, discusses the role of specific pre- and pro-biotics in relieving constipation and explains the importance of diversity of fibres in the diet.


Sandra Mikhail is an internationally-known accredited practising dietitian and the founder and director of Nutrition A-Z by Sandra Mikhail. She holds a Bachelor of Nutrition and Dietetics (Monash University, Australia), a Master of Advanced Studies in Nutrition and Health (ETHZ) and is a member of Dietitians Australia. She also holds a Sports Nutrition Diploma by the International Olympic Committee (IOC). Being a globe-trotting dietitian, she has extensive experience in clinical practice, nutrition consulting and health promotion, working in Australia, the UAE and Switzerland. Her main areas of specialty are digestive disease, sports nutrition and eating disorders working with popular brands and partners such as the Swiss football club FCZ, She’s Mercedes, Lululemon and Adobe to name a few. As a mental health advocate, her workshops and articles on stress and nutrition have gained popularity internationally where she was personally invited by Arianna Huffington to contribute to her global platform Thrive and has appeared on CNN to talk about nutrition and stress in the workplace.


In this episode, we discuss:

  • Sandra’s career journey and how she became an internationally renowned dietitian working in Switzerland
  • The diagnostic criteria for constipation
  • The many causes of constipation
  • Where pre-, pro- and post-biotic research currently stands
  • Specific pre- and pro-biotics used in constipation management
  • Why fibre diversity is so important for gut health
  • How to work effectively within a multidisciplinary team

Additional resources

The Culture Co

Dairy Farmers Gut Active

How to choose a probiotic factsheet

Functional foods factsheet


Werth, L et al. Defining constipation to estimate its prevalence in the community: results from a national survey, BMC Gastroenterology 2019

Hayat, U et al. Chronic constipation: Update on management, Cleve Clin J Med 2017.

Chr Hansen. The science behind Bifidobacterium. BB-12®. Chr Denmark.

Gopal, P et al. 2003, Effects of the consumption of Bifidobacterium lactis HN019 (DR10TM) and galacto oligosaccharides on the microflora of the gastrointestinal tract in human subjects

This podcast is not, and is not intended to be, medical advice, which should be tailored to your individual circumstances. This podcast is for your information only, and we advise that you exercise your own judgment before deciding to use the information provided. Professional medical advice should be obtained before taking action.  Please see here for terms and conditions.


Supported by The Culture Co. and Dairy Farmers Gut Active as part of Gut Health Month

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