Prune intake ameliorates chronic constipation symptoms and causes little discomfort from diarrhea and loose stools: A randomized placebo-controlled trial

Aim: Little data is available regarding the effectiveness of natural foods in treating chronic constipation. We aimed to identify whether prune ameliorates chronic constipation and can be used safely for a relatively long time. Methods: In this double-blind, randomized, placebo-controlled trial, 84 subjects with chronic constipation, presenting more than 6 months before and persisting for more than 3 months, were randomized to prune (n=42) or placebo (n=42) intake for 8 weeks. We assessed daily Bristol stool form scale (BSFS) scores and stool frequencies and administered the gastrointestinal symptom rating scale (GSRS) questionnaire, as primary outcomes for constipation improvement. Results: The prune group showed significantly decreased rates of hard stool (BSFS1 or 2) and increased rates of normal stool (BSFS 3 or 4) after 1 week, which were more evident after 7 weeks between the two groups. Prune significantly increased stool frequency immediately after 1 week. Furthermore, GSRS of hard stools, flatulence, and incomplete evacuation significantly improved after 4-8 weeks of prune intake, of which constipation and hard stools were significantly reduced compared to the placebo group. In contrast, prune intake did not cause diarrhea, loose stools, or urgent need for defecation during 8 weeks evaluated by GSRS score. We found no abnormal laboratory tests of liver function, renal function, inflammation, or urinalysis after prune intake. Conclusions: Daily prune intake ameliorates chronic constipation, improving quality of life, and causes few diarrhea-related symptoms or side effects. Our results emphasize a new, useful, and easy strategy for chronic constipation. (UMIN ID:000041384)

Comparing Golqand (Persian Medicine Product) with Magnesium Hydroxide in Adult Constipation: A Randomized Clinical Trial

Chronic constipation is a highly prevalent digestive problem in the community, which would decrease the quality of life of individuals. There is not any conclusive drug of choice for constipation. Golqand (combined Rosa × damascena Herrm. and honey) has been introduced as an effective safe laxative in Persian medicine (PM). This study aimed to investigate the effects of Golqand in comparison with Magnesium hydroxide suspension (MOM) in chronic constipation. In this clinical trial, fifty-six patients with chronic constipation were randomly assigned to the study groups of Golqand or MOM. Patients received Golqand (20 g daily) or MOM (40 mL daily) for 2 weeks. Patients took the drug twice a day, MOM group used it in the morning (20 mL) and at night before going to bed (20 mL). The Golqand group used it 10 g before lunch and 10 g before dinner, dissolved it in lukewarm water and swallowed. Then, they were followed for the second two weeks without any medication. The primary outcome was frequency of defecation. Patients were evaluated before the study and two weeks and four weeks after the beginning study. Estimated marginal mean frequency of defecation in the MOM group in the first two weeks was significantly higher than the Golqnd group (P < 0.05). There was no significant difference among the groups in the third week when treatment was discontinued (P = 0.155) but in the fourth week, the Golqand group had more count of defecation than the MOM group (P = 0.001). There was no significant difference between the two study groups in terms of treatment satisfaction and drug side effects (P > 0.05). Golqand medication can be used in the treatment of constipation with very few drug side effects and a more lasting effect than MOM drug.

A randomised, double-blind, placebo-controlled trial of Bifidobacterium bifidum CCFM16 for manipulation of gut microbiota and relief from chronic constipation

A variety of opinions exist on the potential of probiotics to provide relief from chronic constipation with much focus placed on their mechanism of action and causes of heterogeneity in...

Chronic constipation: modern view on the problem. A review

Chronic constipation is a frequently diagnosed heterogeneous pathology that significantly impairs the quality of life in all population groups and its frequency increases with age. It commonly affects up to 10 — 15 % of the population. There are numerous classifications of constipation due to a great number of disorders that cause it. The types of constipation are identified based on the etiology or mechanism of its development. Different criteria are used to specify the categorization of constipation, but it is still difficult to find one general classification including all types of constipation. The Rome IV criteria categorize disorders of chronic constipation into four subgroups. The treatment depends on the subtype. The significant increase of constipation cases is observed nowadays. This disorder is facilitated by a sedentary lifestyle, insufficient amount of fiber and fluid in the diet, a wide range of diseases that directly lead to the development of chronic constipation, congenital and acquired pathologies, abnormal intake of laxatives and opioids or a combination of these factors. Despite numerous publications on slow transit constipation, the latter is still the subject of research for many specialists. A lot of recent scientific works have been dedicated to the immunohistochemical studies of interstitial pacemaker cells. The numbers of markers they express were found. Consequently, the investigations of modern scientists are aimed to develop and implement new laboratory methods for determining the indications for surgical treatment depending on a diagnosed disorder of the intestinal neurophysiology. These methods will ensure a differentiated selection of patients for surgical treatment. The step approach to the diagnosis of chronic constipation allows choosing an adequate treatment method in order to improve symptoms, the quality of life, and patient satisfaction. The literature review indicates that surgery still remains the most radical treatment method for patients with slow transit constipation.

Diagnosis and Treatment of Elderly and Senile Chronic Constipation: an Expert Consensus

Aim. An appraisal of practitioners with chronic constipation management details in older and senile adults.Key points. Chronic constipation is a common issue in geriatrics. Aside to age-related physiological bowel disfunction, a higher constipation incidence is conditioned by declined physical activity and frailty, polypharmacy and a series of secondary constipation-developing chronic states and diseases. Chronic constipation is associated with a higher risk of cardiovascular disease and complications, impaired general perception of health and pain, growing alarm and depression, and reduced quality of life. The treatment tactics in chronic constipation is cause-conditioned and should account for the patient’s history and therapy line, overall clinical condition, cognitive status and functional activity level. An essential baseline aspect of constipation management is apprising the patient and his family of the underlying factors and methods for non-drug and drug correction. An higher-fibre diet is recommended as first measure, with osmotic laxatives added and titrated to clinical response if none observed towards the non-drug and high-fibre regimens. Stimulant laxatives and prokinetics should be recommended in patients reluctant to fibre supplements and osmotic laxatives. Subsidiary correction includes biofeedback, transanal irrigation, acupuncture, foot reflexology and percutaneous tibial nerve stimulation.Conclusion. Elderly and senile chronic constipation is a prevalent multifactorial state requiring an efficient management via assessment and correction of total risk factors and consistent use of non-medication and drug therapies.