Randomised clinical trial: Dried plums (prunes) vs. psyllium for constipation

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, randomised 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.