An effective treatment for constipation?

Researchers from Japan, New Zealand and Italy enrolled 60 patients with functional constipation, 61 with constipation-predominant irritable bowel syndrome (IBS-C) between June 2014, and June 2017 to examine the effect of eating green kiwifruit on constipation. Sixty-three healthy adults acted as the control group. The participants were instructed to maintain a bowel diary for 2 weeks after their inclusion in the study. They were then randomized to either receive two green kiwifruits or 7.5 g psyllium daily for 4 weeks, then a 4-week wash-out when treatment was stopped followed by rescue treatment (bisacodyl suppositories) for 4 weeks.

After eating kiwifruits, patients with functional constipation reported an increase of 1.53 in the number of complete spontaneous bowel movements per week, which was the primary outcome of the study compared to patients who took psyllium. In the IBS-C group, the number increased by 1.73. On the other hand, in the psyllium-treated patients, only those with IBS-C showed an increase in the bowel movements of 1.87 per week. The bowel movements did not increase in the control group.

Gastrointestinal (GI) comfort, the secondary outcome, improved markedly in both groups as assessed by gastrointestinal symptom rating scale with softer stools, less bowel straining, abdominal pain. But the improvements were better in the kiwi fruit consumers. There were no major adverse events.

Whole fresh fruits are a rich source of fiber. Ensuring adequate dietary fiber is the first step in the management of patients with chronic constipation. This study suggests green kiwifruit as a rich source of natural dietary fiber and has demonstrated its effectiveness in relieving constipation including the associated GI discomfort in patients with functional constipation and IBS-C.

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