Chey SW, et al. Abstract: S0454. Presented at the American College of Gastroenterology Annual Scientific Meeting (Virtual). Oct. 23-28, 2020.
Kiwi fruit effective, well tolerated in treating chronic constipation
Two peeled kiwi fruit per day improved chronic constipation while being better tolerated than other traditional natural remedies, according to a randomized study presented at ACG 2020 Virtual.
“While there are many therapeutic options available for chronic constipation, they only lead to about half of patients feeling better and only offer therapeutic gain of 10% to 15% over placebo showing the need for additional forms of therapy,” Samuel W. Chey, MPH, of University of Michigan, said during his virtual presentation. “Furthermore, consumer shifts in chronic medication, safety and preferences have drawn the public towards more natural solutions for chronic constipation.”
Though prunes and psyllium have been shown in U.S. studies to affect constipation, kiwi fruit has not been previously studied in the U.S. Because it is lower on the FODMAP scale, Chey and colleagues sought to compare it with the two more traditional natural remedies.
The researchers randomly assigned 79 patients with chronic constipation to receive one of three natural constipation treatments – prunes (12 peeled), psyllium (100 g) or green kiwi fruit (two peeled) – daily for 4 weeks.
All three treatments improved complete spontaneous bowel movement (P .003). Prunes demonstrated the largest magnitude of response at 67% vs. 64% for psyllium vs. 45% for Kiwi fruit, Chey said.
Stool consistency improved with kiwi (P = .01) and prunes (P = .049) and straining significantly improved with kiwi (P = .003), prunes (P < .001) and psyllium (P = .04). Adverse events were most common with psyllium and least common with kiwi. At the end of treatment, a smaller proportion of patients were dissatisfied with kiwi compared with prunes or psyllium (P = .02).
“The highest proportion of participants – 68% – reported treatment satisfaction with kiwifruit while similar proportions of those receiving prunes and psyllium – 48% – reported satisfaction,” Chey said. “The kiwi group had the lowest proportion of participants reporting treatment dissatisfaction at 7%. In fact, there was a statistically significantly lower likelihood of kiwifruit participants reporting treatment dissatisfaction compared to prunes or psyllium at 17% and 38%, respectively.”
Participants receiving prunes and psyllium were more likely to report abdominal pain and bloating than those receiving kiwi, Chey added. Of the participants who received kiwi, 0% reported abdominal pain or gas compared with 18% for both in the prunes group and 33% pain and 19% gas in the psyllium group.
“Prunes and psyllium are reconfirmed as effective options to treat chronic constipation with prunes demonstrating the strongest response for our primary outcome,” Chey said. “And for the first time in the North American population, kiwifruit was shown to be an effective well-tolerated and well-received natural treatment option for chronic constipation.”