S0454 Randomized, Comparative Effectiveness Trial of Green Kiwifruit, Psyllium, or Prunes in U.S. Patients with Chronic Constipation

Chey, Samuel W.; Chey, William D.; Jackson, Kenya; Eswaran, Shanti

doi:10.14309/ajg.0000000000000851

Cited by 3 publications

(2 citation statements)

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“…Fruit fibre (eg, prunes 51 ) or mixed soluble fibre 52 has demonstrated a short‐term efficacy in the management of chronic constipation, somewhat better than psyllium. In a recent randomised controlled trial of natural treatments for CIC in 79 patients, kiwifruit, psyllium and prunes were found to be effective 53 …”

Section: Treatmentmentioning

confidence: 99%

“…In a recent randomised controlled trial of natural treatments for CIC in 79 patients, kiwifruit, psyllium and prunes were found to be effective. 53 Physical activity has been associated with reduced GI transit times. 50 Although exercise alone does not appear to improve constipation, patients report improved QoL and a reduction in symptom severity.…”

Section: Lifestyle and Dietary Modificationsmentioning

confidence: 99%

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Review article: diagnosis, management and patient perspectives of the spectrum of constipation disorders

Sharma

Rao

Kearns

et al. 2021

Aliment Pharmacol Ther

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Summary Background Chronic constipation is a common, heterogeneous disorder with multiple symptoms and pathophysiological mechanisms. Patients are often referred to a gastroenterology provider after laxatives fail. However, there is limited knowledge of the spectrum and management of constipation disorders. Aim To discuss the latest understanding of the spectrum of constipation disorders, tools for identifying a pathophysiologic‐based diagnosis in the specialist setting, treatment options and the patient's perspective of constipation. Methods Literature searches were conducted using PubMed for constipation diagnostic criteria, diagnostic tools and approved treatments. The authors provided insight from their own practices. Results Clinical assessment, stool diaries and Rome IV diagnostic criteria can facilitate diagnosis, evaluate severity and distinguish between IBS with constipation, chronic idiopathic constipation and dyssynergic defecation. Novel smartphone applications can help track constipation symptoms. Rectal examinations, anorectal manometry and balloon expulsion, assessments of neuromuscular function with colonic transit time and colonic manometry can provide mechanistic understanding of underlying pathophysiology. Treatments include lifestyle and diet changes, biofeedback therapy and pharmacological agents. Several classes of laxatives, as well as prokinetic and prosecretory agents, are available; here we describe their mechanisms of action, efficacy and side effects. Conclusions Constipation includes multiple overlapping subtypes identifiable using detailed history, current diagnostic tools and smartphone applications. Recognition of individual subtype(s) could pave the way for optimal, evidence‐based treatments by a gastroenterology provider.

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Section: Treatmentmentioning

confidence: 99%

Section: Lifestyle and Dietary Modificationsmentioning

confidence: 99%