13/01/2023
Chronic constipation can be difficult to manage. My favourite dietary recommendations for patients suffering from constipation are pears, prunes and gold kiwi fruit, in relatively large amounts if needed. Evidence from recent clinical trials supports this advice.
A clinical trial from New Zealand aimed to improve chronic constipation with two gold kiwifruit and daily over four weeks. Psyllium was given in lieu of a placebo. Adult participants (18to 65 years) with functional constipation (FC, n = 11), constipation-predominant irritable bowel syndrome (IBS-C, n = 13), and healthy controls (n = 32) were block-randomised to the treatment order: gold kiwifruit (2/day) or psyllium (fibre-matched, 7.5 g/day) for four weeks, followed by four weeks washout before crossover treatment. Outcomes included alterations of Gastrointestinal Symptom Rating Scale (GSRS) domains and weekly complete spontaneous bowel movements (CSBM) as part of a larger study. Both interventions reduced GSRS constipation domain scores in all participants compared with baseline values (p = 0.004). All participants reported significantly more weekly CSBM (p = 0.014). Two gold kiwifruit decreased straining (p = 0.021). The authors concluded that two gold kiwifruit daily are as effective as fibre-matched psyllium in treating constipation in adults and should be considered as a treatment option. For more details see https://pubmed.ncbi.nlm.nih.gov/36235798/
A Japanese double blind, randomised, placebo-controlled clinical trial was undertaken to determine the efficacy of prune juice on chronic constipation. This study included 84 participants aged 20โ75 years who presented with symptoms of treatment-naive chronic constipation. The criterion for chronic constipation was defined according to Rome IV as fewer than 3 bowel movements per week and/or hard stool, as defined by the Bristol Stool Form Scale (BSFS) 1 or 2, for the past 3 months, with symptom onset at least 6 months earlier. People were randomly assigned to the prune juice group or placebo group and consumed 54 g of each test food in a day for 8 weeks. The placebo was designed to match the flavour, colour and taste of prune juice.
Prune juice intake significantly decreased hard and lumpy stools while increasing normal stool, but without increasing loose and watery stools. Prune intake also ameliorated subjective complaints of constipation and hard stools, without alteration of flatulence, diarrhoea, loose stools, or urgent need for defecation. There were no adverse events or laboratory abnormalities for liver or renal function after prune intake. For more details see https://pubmed.ncbi.nlm.nih.gov/35971232/
