Prunes: A Natural Remedy for Constipation

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Prunes, figs, and exercise are put to the test as natural home remedies for constipation.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The act of defecation involves a very private sphere and is the object of cultural taboos, so much so that it’s rarely thought of, even by physicians—but it should be. Constipation accounts for three million annual visits to doctors in the United States and 800,000 emergency room visits. Depending on how you define it, up to 80 percent of the population may be suffering. Even people who don’t think they’re constipated may very well be clinically constipated. A quarter of their so-called healthy subjects reported experiencing incomplete emptying, and approximately half indicated increased straining. In fact, more than half had found blood on their toilet paper within the past year. In severe cases, the blood pressure spike associated with straining at stool can even trigger a heart attack or a stroke.

There are drugs for it. There are always drugs, resulting in side effects like headache, nausea, diarrhea, and abdominal pain, leaving most patients unsatisfied. So why not instead just try to treat the cause? Common causes of chronic constipation include lack of adequate whole plant foods or insufficient water intake, and so making changes in the patient’s diet and lifestyle is the preferred method for relieving constipation. Such nonpharmacological clinical effective interventions include engaging in physical activity for about 30 min a day.

A systematic review and meta-analysis found aerobic exercise interventions help, starting at about 140 minutes a week. And then, of course, a diet centered around whole plant foods, which are the only naturally concentrated sources of fiber. Any plants in particular?

If you give elderly women with severe constipation about a dozen prunes a day they experience significant improvement within the first week. The control group in the study wasn’t told to do anything though. And any time you have one group doing something and the other doing nothing, you can’t discount the placebo effect. And the placebo response for constipation trials can range up to 44 percent, meaning up to nearly half of the people given a sugar pill claimed to experience an improvement. So, that’s why we need studies like this.

Subjects were randomized to about 8 prunes a day plus a large glass of water; 12 prunes and water; or just the water alone; so, even the control group got an intervention they were told might help with constipation. Previous studies mostly assigned 10 prunes or so a day, so the researchers wanted to see if more was better or less was sufficient and…they found a significant improvement in stool bulk on the prunes and a significant increase in bowel movement frequency, though no real difference between 8 and 12; so, 8 a day seems sufficient. Prunes even appear superior to psyllium, sold as Metamucil, beating it out in terms of improved stool frequency and consistency.

We used to think it was just all the fiber in prunes that was helping, but prune juice evidently works too, which, like most juices, has had the fiber removed. Other potential active components include a natural sugar alcohol known as sorbitol that’s used in some sugar-free gum. Once you eat more than a dozen or so large prunes a day, however, the dose of sorbitol could start reaching laxative levels in susceptible individuals. So, be careful.

If you don’t have constipation, should you avoid prunes? That’s been put to the test, and… most people should be able to eat a dozen or so a day without any issues. In fact, it’s interesting to note that prunes have been traditionally used as both a laxative and an antidiarrheal remedy.

What about dried figs, one of the few medicinal plants mentioned explicitly in the Bible. Researchers took patients with the type of irritable bowel syndrome characterized by constipation and randomized them to one fig with breakfast and one fig with lunch, each with a glass of water, and there was a significant improvement in frequency of defecation and a significant drop in the frequency of hard stools, compared to control. Ah, but what was the control? The control group was just asked to continue their normal diet. In other words, to do nothing special. The placebo response for irritable bowel is infamous. Give people with IBS a fake sugar pill, and sometimes 72 percent say they magically feel better. That’s why we need this kind of study: a randomized, double-blind, placebo-controlled trial. Researchers made a gross-sounding placebo fig paste placebo that supposedly had the same taste, smell, and appearance as the real deal. Those who got the real figs, about six a day, seemed to improve colon transit time, stool consistency, and abdominal discomfort compared to the placebo. Researchers measured transit time by having people swallow little beads that would show up on x-rays so they could track the progress thorough their digestive system. They found that those eating the real figs sped up their gut movement by a full 24 hours. Defecation frequency per week didn’t beat out placebo though, and in fact, they tested so many different outcomes even the stool consistency and tummy discomfort results may have been statistical flukes. So, it looks like prunes would be the better treatment choice.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

The act of defecation involves a very private sphere and is the object of cultural taboos, so much so that it’s rarely thought of, even by physicians—but it should be. Constipation accounts for three million annual visits to doctors in the United States and 800,000 emergency room visits. Depending on how you define it, up to 80 percent of the population may be suffering. Even people who don’t think they’re constipated may very well be clinically constipated. A quarter of their so-called healthy subjects reported experiencing incomplete emptying, and approximately half indicated increased straining. In fact, more than half had found blood on their toilet paper within the past year. In severe cases, the blood pressure spike associated with straining at stool can even trigger a heart attack or a stroke.

There are drugs for it. There are always drugs, resulting in side effects like headache, nausea, diarrhea, and abdominal pain, leaving most patients unsatisfied. So why not instead just try to treat the cause? Common causes of chronic constipation include lack of adequate whole plant foods or insufficient water intake, and so making changes in the patient’s diet and lifestyle is the preferred method for relieving constipation. Such nonpharmacological clinical effective interventions include engaging in physical activity for about 30 min a day.

A systematic review and meta-analysis found aerobic exercise interventions help, starting at about 140 minutes a week. And then, of course, a diet centered around whole plant foods, which are the only naturally concentrated sources of fiber. Any plants in particular?

If you give elderly women with severe constipation about a dozen prunes a day they experience significant improvement within the first week. The control group in the study wasn’t told to do anything though. And any time you have one group doing something and the other doing nothing, you can’t discount the placebo effect. And the placebo response for constipation trials can range up to 44 percent, meaning up to nearly half of the people given a sugar pill claimed to experience an improvement. So, that’s why we need studies like this.

Subjects were randomized to about 8 prunes a day plus a large glass of water; 12 prunes and water; or just the water alone; so, even the control group got an intervention they were told might help with constipation. Previous studies mostly assigned 10 prunes or so a day, so the researchers wanted to see if more was better or less was sufficient and…they found a significant improvement in stool bulk on the prunes and a significant increase in bowel movement frequency, though no real difference between 8 and 12; so, 8 a day seems sufficient. Prunes even appear superior to psyllium, sold as Metamucil, beating it out in terms of improved stool frequency and consistency.

We used to think it was just all the fiber in prunes that was helping, but prune juice evidently works too, which, like most juices, has had the fiber removed. Other potential active components include a natural sugar alcohol known as sorbitol that’s used in some sugar-free gum. Once you eat more than a dozen or so large prunes a day, however, the dose of sorbitol could start reaching laxative levels in susceptible individuals. So, be careful.

If you don’t have constipation, should you avoid prunes? That’s been put to the test, and… most people should be able to eat a dozen or so a day without any issues. In fact, it’s interesting to note that prunes have been traditionally used as both a laxative and an antidiarrheal remedy.

What about dried figs, one of the few medicinal plants mentioned explicitly in the Bible. Researchers took patients with the type of irritable bowel syndrome characterized by constipation and randomized them to one fig with breakfast and one fig with lunch, each with a glass of water, and there was a significant improvement in frequency of defecation and a significant drop in the frequency of hard stools, compared to control. Ah, but what was the control? The control group was just asked to continue their normal diet. In other words, to do nothing special. The placebo response for irritable bowel is infamous. Give people with IBS a fake sugar pill, and sometimes 72 percent say they magically feel better. That’s why we need this kind of study: a randomized, double-blind, placebo-controlled trial. Researchers made a gross-sounding placebo fig paste placebo that supposedly had the same taste, smell, and appearance as the real deal. Those who got the real figs, about six a day, seemed to improve colon transit time, stool consistency, and abdominal discomfort compared to the placebo. Researchers measured transit time by having people swallow little beads that would show up on x-rays so they could track the progress thorough their digestive system. They found that those eating the real figs sped up their gut movement by a full 24 hours. Defecation frequency per week didn’t beat out placebo though, and in fact, they tested so many different outcomes even the stool consistency and tummy discomfort results may have been statistical flukes. So, it looks like prunes would be the better treatment choice.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

What about carbonated drinks? See Club Soda for Stomach Pain and Constipation.

I previously discussed prunes and constipation in Prunes vs. Metamucil vs. Vegan Diet.

What else can prunes do? See Prunes for Osteoporosis.

And what is The Best Poop Position for Constipation? Watch the video to find out!

Can we do anything else for IBS? Check out:

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