The effect of green kiwifruit on gas transit and tolerance in healthy humans.

Noemi Caballero,Juliet Ansell,Bouchra Benslaiman,Jordi Serra

doi:10.1111/nmo.13874

Abstract

BackgroundGreen kiwifruit is a fiber‐rich fruit that has been shown effective for treatment of constipation. However, fermentation of fibers by colonic bacteria may worsen commonly associated gas‐related abdominal symptoms. Aim: To determine the effect of green kiwifruit on transit and tolerance to intestinal gas in humans.MethodsIn 11 healthy individuals, two gas challenge tests were performed (a) after 2 weeks on a low‐flatulogenic diet and daily intake of 2 green kiwifruits and (b) after 2 weeks on a similar diet without intake of kiwifruits. The gas challenge test consisted in continuous infusion of a mixture of gases into the jejunum at 12 mL/min for 2 hours while measuring rectal gas evacuation, abdominal symptoms, and abdominal distension. During the 2 weeks prior to each gas challenge test (on‐kiwifruit and off‐kiwifruit), the number and consistency of stools, and abdominal symptoms were registered.Key ResultsIntake of kiwifruits was associated with more bowel movements per day (1.8 ± 0.1 vs 1.5 ± 0.1 off‐kiwifruit; P = .001) and somewhat looser stools (Bristol score 3.3 ± 0.2 vs 2.8 ± 0.1 off‐kiwifruit; P = .072) without relevant abdominal symptoms. Gas infusion produced similar gas evacuation (1238 ± 254 mL and 1172 ± 290 mL; P = .4355), perception of symptoms (score 1.2 ± 0.2 and 1.3 ± 0.3; P = .2367), and abdominal distension (17 ± 7 mm and 17 ± 6 mm; P = .4704) while on‐kiwifruit or off‐kiwifruit.Conclusions and InferencesIn healthy subjects, green kiwifruit increases stool frequency without relevant effects on intestinal gas transit and tolerance. If confirmed in patients, these fruits may provide a natural and well‐tolerated treatment alternative for constipation.

Highlights

In the present study performed in healthy subjects, we have shown that daily intake of two green kiwifruits per day increases stool frequency and soften the stools without inducing gas-related abdominal symptoms, without increasing rectal gas evacuation, and without effects on gas transit and tolerance to intestinal gas loads
Patients with constipation often complain of associated symptoms like bloating and abdominal distension, which may worsen after fiber consumption due to the increased intestinal water and gas volumes induced by fermentation of the complex polysaccharides that are components of natural fibers.[9,30]
Despite its potential gas production, during the 2 weeks kiwifruit intake participants did not complain of any gas-related abdominal symptoms, and when a gas infusion test was performed, the volume of gas expelled was similar whether the subject had been on-kiwifruit or off-kiwifruit during the 2 weeks prior the gas infusion test

Summary

Introduction

Kiwifruit is a fruit rich in fibers, C, E, and K vitamins, folate, potassium, and other phytochemicals that has been shown to have several beneficial effects on gastrointestinal health.[1,2] kiwifruit has been shown to accelerate gastric and colonic transit, soften the stools, and to improve constipation, an effect that can be partially mediated by the high fiber contents of kiwifruit.[3,4,5] Patients with constipation and other related functional gut disorders like constipation-predominant irritable bowel syndrome often refer gas-related abdominal complains, like bloating and abdominal distension, that in many cases are referred as their most bothersome symptoms.[6,7] Fibers have a high potential to produce intestinal gas by increasing bacterial fermentation in the colon, and the development of gas-related abdominal symptoms may be a limiting factor for prescription and intake of fibers and some laxatives like lactulose that are fermented by colonic bacteria.[8,9,10]Kiwifruits contain 1.4-3.0 g. of dietary fiber per 100 g. of fruit. A prokinetic effect of kiwifruit[5] could accelerate transit and removal of intestinal gas, and thereby prevent gas-related abdominal symptoms while improving constipation. Green kiwifruit is a fiber-rich fruit that has been shown effective for treatment of constipation. Aim: To determine the effect of green kiwifruit on transit and tolerance to intestinal gas in humans. Gas infusion produced similar gas evacuation (1238 ± 254 mL and 1172 ± 290 mL; P = .4355), perception of symptoms (score 1.2 ± 0.2 and 1.3 ± 0.3; P = .2367), and abdominal distension (17 ± 7 mm and 17 ± 6 mm; P = .4704) while on-kiwifruit or off-kiwifruit. Conclusions and Inferences: In healthy subjects, green kiwifruit increases stool frequency without relevant effects on intestinal gas transit and tolerance. These fruits may provide a natural and well-tolerated treatment alternative for constipation

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