PMID- 34074830
OWN - NLM
STAT- MEDLINE
DCOM- 20210630
LR  - 20210630
IS  - 1572-0241 (Electronic)
IS  - 0002-9270 (Linking)
VI  - 116
IP  - 6
DP  - 2021 Jun 1
TI  - Exploratory Comparative Effectiveness Trial of Green Kiwifruit, Psyllium, or 
      Prunes in US Patients With Chronic Constipation.
PG  - 1304-1312
LID - 10.14309/ajg.0000000000001149 [doi]
AB  - INTRODUCTION: Psyllium and prunes are proven treatments for chronic constipation 
      (CC). Asian studies suggest that kiwifruit may also benefit CC symptoms. We 
      report a partially randomized, comparative effectiveness trial evaluating 
      kiwifruit, psyllium, and prunes in US patients with CC. METHODS: Adults with CC 
      at a US medical center were randomized to 3 natural treatments. Eligible patients 
      had </=3 complete spontaneous bowel movements (CSBMs) per week and were partially 
      randomized to green kiwifruit (2/d), prunes (100 g/d), or psyllium (12 g/d) for 4 
      weeks. The primary endpoint was the proportion of patients in each group 
      reporting an increase of >/=1 CSBM per week compared with baseline for at least 2 
      of 4 treatment weeks. Key secondary outcomes included stool frequency, stool 
      consistency, and straining assessed daily. Treatment satisfaction and adverse 
      events (AEs) were also measured. Standard statistical methods were used, and a P 
      < 0.05 was considered significant. RESULTS: Seventy-nine patients with CC (mean 
      age = 42.7 years, 87% female, and 77% white) were partially randomized. Complete 
      data were available for 75 patients (kiwifruit 29, prunes 24, and psyllium 22). 
      For the primary endpoint, proportions of CSBM responders were similar for the 
      treatments. For secondary outcomes comparing treatment weeks 3 and 4 to baseline, 
      there was a significant increase in weekly CSBM rate with all 3 treatments (P </= 
      0.003); stool consistency significantly improved with kiwifruit (P = 0.01) and 
      prunes (P = 0.049); and straining significantly improved with kiwifruit (P = 
      0.003), prunes (P < 0.001), and psyllium (P = 0.04). Patients randomized to the 
      kiwifruit group reported significant improvement in bloating scores (P = 0.02). 
      AEs were most common with psyllium and least common with kiwifruit. At the end of 
      treatment, a smaller proportion of patients were dissatisfied with kiwifruit 
      compared with prunes or psyllium (P = 0.02). DISCUSSION: Kiwifruit, prunes, and 
      psyllium improve constipation symptoms in patients with CC. Kiwifruit was 
      associated with the lowest rate of AEs and dissatisfaction with therapy.
CI  - Copyright (c) 2021 by The American College of Gastroenterology.
FAU - Chey, Samuel W
AU  - Chey SW
AD  - Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, 
      Ann Arbor, Michigan, USA.
FAU - Chey, William D
AU  - Chey WD
AD  - Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, 
      Ann Arbor, Michigan, USA.
FAU - Jackson, Kenya
AU  - Jackson K
AD  - Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, 
      Ann Arbor, Michigan, USA.
AD  - Departments of Pulmonology and Research, Veteran's Affairs Healthcare System of 
      Atlanta, North Druid Hills, Georgia, USA.
FAU - Eswaran, Shanti
AU  - Eswaran S
AD  - Division of Gastroenterology, Department of Internal Medicine, Michigan Medicine, 
      Ann Arbor, Michigan, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT00356952
SI  - ClinicalTrials.gov/NCT03569527
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Gastroenterol
JT  - The American journal of gastroenterology
JID - 0421030
RN  - 8063-16-9 (Psyllium)
SB  - IM
MH  - Actinidia
MH  - Adult
MH  - Chronic Disease
MH  - Comparative Effectiveness Research
MH  - Constipation/*diet therapy
MH  - Female
MH  - *Fruit
MH  - Humans
MH  - Male
MH  - Prunus
MH  - Psyllium/*therapeutic use
EDAT- 2021/06/03 06:00
MHDA- 2021/07/01 06:00
CRDT- 2021/06/02 05:59
PHST- 2020/06/19 00:00 [received]
PHST- 2020/11/13 00:00 [accepted]
PHST- 2021/06/02 05:59 [entrez]
PHST- 2021/06/03 06:00 [pubmed]
PHST- 2021/07/01 06:00 [medline]
AID - 00000434-202106000-00030 [pii]
AID - 10.14309/ajg.0000000000001149 [doi]
PST - ppublish
SO  - Am J Gastroenterol. 2021 Jun 1;116(6):1304-1312. doi: 
      10.14309/ajg.0000000000001149.