Dried plums beat psyllium for constipation

A paper just published in the the journal Alimentary Pharmacology and Therapeutics pitted dried plums against psyllium in a randomised clinical trial to determine if either is more effective in treating chronic constipation. The authors first observe:

"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."

Over the course of an 8-week, single-blind, randomised cross-over study, subjects received either dried plums (50 g 2x/day; 50 g = 1.76 oz) or psyllium for 3 weeks each. They then swapped after a 1-week washout period. Outcome considerations included the number of complete spontaneous bowel movements per week, overall relief of constipation, stool consistency, straining and tolerability. What did they find?

"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 with dried plums when compared to psyllium."

Whether dried plums also contribute beneficial flavonoids is a possibility worth looking into. Clinicians should, of course, educate patients that the underlying causes of chronic constipation must be determined and properly treated. Meanwhile we can keep in mind the authors' conclusion for palliative care:

"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."