Randomised clinical trial: dried plums (prunes)

vs. psyllium for constipation.

A. Attaluri, R. Donahoe, J. Valestin, K. Brown & S. S. C. Rao

Background

Treatment of chronic constipation remains

challenging with 50% of patients dissatisfied

with current therapy. There is an unmet need

for natural and safe alternatives. Dried plums

(prunes) have been used traditionally for

constipation but their efficacy is not known.

Aim

To assess and compare the effects of dried

plums and psyllium in patients with chronic

constipation.

Methods

Subjects were enrolled in an 8-week,

single-blind, randomized cross-over

study. Subjects received either dried plums

(50 g b.d., fibre = 6 gm⁄ day) or psyllium

(11 g b.d., fibre = 6 gm⁄ day) for 3 weeks

each, in a crossover trial with a 1-week

washout period. Subjects maintained a

daily symptom and stool diary. Assessments

included number of complete spontaneous

bowel movements per week, global relief

of constipation, stool consistency, straining,

tolerability and taste.

Results

Forty constipated subjects (m⁄ f = 3⁄ 37,

mean age = 38 years) participated.

The number of complete spontaneous

bowel movements per week (primary

outcome measure) and stool consistency

scores improved significantly(P < 0.05)

with dried plums when compared to

psyllium. Straining and global constipation

symptoms did not differ significantly

between treatments (P = N.S.). Dried

plums and psyllium were rated as equally

palatable and both were safe and well

tolerated.

Conclusion

Dried plums are safe, palatable and more

effective than psyllium for the treatment

of mild to moderate constipation, and

should be considered as a first line therapy.