Investigation of Dried Plums in Constipation - A Randomized Controlled Trial

Abstract

Purpose: Treatment of chronic constipation (CC) remains challenging with 50% of patients reporting dissatisfaction with current therapy. There is an unmet need for natural, safe, convenient and tasty alternatives. Dried plums/ prunes have been traditionally used for CC but its efficacy is not known. Aim: To investigate and compare the effects of dried plums and psyllium on constipation symptoms, taste and tolerability. Methods: Subjects with CC (Rome III) were enrolled in an 8 week, single-blinded, randomized cross-over study. After a one week assessment of baseline stool and bowel symptoms on a prospective diary, subjects received either dried plums (50 grams BID, fiber = 6 gm/day) or psyllium (11 grams BID, fiber = 6 gm/day) for 3 weeks each. Next, after a one week wash out period, they were crossed over to the other therapy for 3 weeks. Subjects maintained a daily symptom and stool diary. Individual and overall constipation related symptoms (rated=-3 (markedly worse) to +3 (markedly better)) and taste were assessed. The primary outcome measure was number of complete spontaneous bowel movements per week (CSBM). Results: (*=p<0.01): 40 constipated subjects (m/f = 3/37, mean age = 38 years) participated. The number of CSBMs per week increased significantly (p<0.01) with both plums and psyllium when compared to baseline but there was no difference between treatments. The stool consistency and straining effort did not change with both treatments (p=ns). Global constipation symptoms improved with plums (+ 1.67) and with psyllium (+1.35), but there was no difference. There were no differences in palatability and tolerability between plums and psyllium, and both were safe. Conclusion: Constipation symptoms improved with both dried plums and with psyllium and to a similar extent. Dried plums are safe and an effective option in the management of (mild to moderate) chronic constipation and should be considered as first line therapy. Supported by grant from California Dried Plum Board and NIH R01 DK057100. This research was a California Dried Plum Board and NIH R01 DK057100.Table