pectins and Constipation

Chronic constipation is a prevalent disorder that remains challenging to treat. Studies suggest increasing fiber intake may improve symptoms, although recommendations on the fiber type, dose, and treatment duration are unclear.. We investigated the effects of fiber supplementation on stool output, gut transit time, symptoms, and quality of life in adults with chronic constipation via a systematic review and meta-analysis of randomized controlled trials (RCTs).. Studies were identified using electronic databases, backward citation, and hand searches of abstracts. RCTs reporting administration of fiber supplementation in adults with chronic constipation were included. Risks of bias (RoB) was assessed with the Cochrane RoB 2.0 tool. Results were synthesized using risk ratios (RRs), mean differences, or standardized mean differences (SMDs) and 95% CIs using a random-effects model.. Sixteen RCTs with 1251 participants were included. Overall, 311 of 473 (66%) participants responded to fiber treatment and 134 of 329 (41%) responded to control treatment [RR: 1.48 (95% CI: 1.17, 1.88; P = 0.001); I2 = 57% (P = 0.007)], with psyllium and pectin having significant effects. A higher response to treatment was apparent in fiber groups compared to control groups irrespective of the treatment duration, but only with higher fiber doses (>10 g/d). Fiber increased stool frequency [SMD: 0.72 (95% CI: 0.36, 1.08; P = 0.0001); I2 = 86% (P < 0.00001)]; psyllium and pectin had significant effects, and improvement was apparent only with higher fiber doses and greater treatment durations (≥4 weeks). Fiber improved stool consistency (SMD: 0.32; 95% CI: 0.18, 0.46; P < 0.0001), particularly with higher fiber doses. Flatulence was higher in fiber groups compared to control groups(SMD: 0.80; 95% CI: 0.47, 1.13; P < 0.00001).. Fiber supplementation is effective at improving constipation. Particularly, psyllium, doses >10 g/d and treatment durations of at least 4 weeks appear optimal, though caution is needed when interpreting the results due to considerable heterogeneity. These findings provide promising evidence on the optimal type and regime of fiber supplementation, which could be used to standardize recommendations to patients. The protocol for this review is registered at PROSPERO as CRD42020191404.

Topics: Adult; Constipation; Dietary Fiber; Dietary Supplements; Humans; Pectins; Psyllium; Randomized Controlled Trials as Topic

Pectin is natural biopolymer derived from various plant sources and its activity is driven by functional groups. Affinity of pectin and chemical interactions of the active sites to chemicals in media determines fate of adjuvant molecules. Pectin is appropriate co-polymer in modulation of drawbacks of other biopolymers such as low glass transition temperature, low water solubility, and susceptibility to human digestive tract. However, functionality of pectin is improved by its optimized complexation with other chemicals especially in food packaging and tissue engineering. In the last decade, several technical and health-related functions of pectin have been studied through which some products designed and marketed progressively. Pectin-based formulations were commercialized in food, medicine, and radioprotection sectors. It is also advised for alleviation of constipation symptoms. Cost-effectiveness of this multifunctional biopolymer compared to the others that are currently used, has introduced it as a potential alternative for the next years.

Topics: Absorption, Physicochemical; Constipation; Digestion; Drug Compounding; Food Packaging; Gastrointestinal Diseases; Humans; Metals, Heavy; Pectins; Radiation-Protective Agents; Solubility; Tissue Engineering; Transition Temperature

The aim of this study was to determine the effectiveness of prune juice on chronic constipation.. We conducted a double-blind, randomized, placebo-controlled trial in Japanese subjects with chronic constipation.. Prune intake significantly decreased hard and lumpy stools while increasing normal stool and not increasing loose and watery stools. Prune intake also ameliorated subjective complaints of constipation and hard stools, without alteration of flatulence, diarrhea, loose stools, or urgent need for defecation. There were no adverse events or laboratory abnormalities of liver or renal function after prune intake.. Prune juice exerted an effective and safe natural food therapy for chronic constipation.

Topics: Constipation; Defecation; Diarrhea; Dietary Fiber; Double-Blind Method; Feces; Humans; Pectins; Polyphenols; Sorbitol

As some studies have reported that strategies targeting the gut microbiota such as fecal microbiota transplantation (FMT) with or without other microecological therapy might have efficacy in treating slow transit constipation (STC), we conducted a single-center, open-label trial to study the long-term effect of FMT combined with soluble dietary fiber (pectin) on STC. Thirty-one adult patients with STC were enrolled into the trial. Patients received 6-day FMT procedures repeatedly for the first 3 months and soluble dietary fiber (pectin) daily during the follow-up. The rate of clinical remission and improvement, stool consistency, the Wexner constipation scale, and assessment of constipation-related symptoms were evaluated at week 4 and 1 year later. The clinical remission and improvement rates at week 4 were 69.0% (20/29) and 75.9% (22/29), respectively. At the end of the study, 48.3% (14/29) of patients continued to have at least three complete spontaneous bowel movements per week and 58.6% (17/29) of patients showed clinical improvements. Stool consistency, the Wexner constipation scale, and constipation symptoms improved both at short-term and long-term follow-up. The results indicated that FMT in combination with soluble dietary fiber (pectin) had both short-term and long-term efficacy in treating STC.

Topics: Adult; Combined Modality Therapy; Constipation; Defecation; Dietary Fiber; Fecal Microbiota Transplantation; Female; Follow-Up Studies; Gastrointestinal Transit; Humans; Male; Middle Aged; Pectins; Treatment Outcome

To explore the effect of pectin, a kind of soluble dietary fiber, on colonic transit time (CTT), clinical symptoms and gut microbiota in adults with slow-transit constipation.. A total of 80 patients with slow-transit constipation were selected between June 2011 and December 2013. For this randomized controlled trial, we evaluated the efficacy of pectin on intestinal transit time and other indices of constipation in adults with slow-transit constipation. They were randomized to receive either pectin or placebo. Treatment consisted of 4-week supplementation with 24 g/d pectin (fiber group) or maltodextrin (placebo group). Before and after 4-week treatment, CTT, constipation symptoms and fecal bacterial population were compared between groups.. CTT of the fiber group after treatment was lower than those of fiber group before treatment and those in the placebo group ((60.2 ± 11.2) h vs (80.3 ± 9.5), (79.4 ± 11.7) h, P < 0.01). Constipation score of the fiber group after treatment also decreased than those of fiber group before treatment and those in the placebo group (both P < 0.05). Bifidobacterium sp. and Lactobacillus sp. evidently increased (lg copies/g:8.26 ± 0.83 vs 6.42 ± 1.07 and 6.48 ± 0.82, 6.83 ± 0.77 vs 5.85 ± 0.64 and 5.91 ± 0.73; all P < 0.05) and total Clostridium sp. significantly decreased (9.07 ± 0.63 vs 9.74 ± 0.81 and 9.66 ± 0.43, P < 0.05) in the fiber group after treatment versus the placebo group. No significant adverse effects were reported.. Four-week soluble dietary fiber use accelerates colon transit time and alleviates clinical symptoms in patients with slow-transit constipation. Additionally, supplementary fiber offers protective effects on gut microbiota by increasing the population of healthy microflora.

Topics: Adult; Colon; Constipation; Dietary Fiber; Dietary Supplements; Feces; Gastrointestinal Transit; Humans; Pectins

Topics: Animals; Arctium; Constipation; Gastrointestinal Motility; Intestine, Small; Laxatives; Mice; Mice, Inbred ICR; Pectins; Plant Roots; Rheology

To evaluate the efficacy and safety of fecal microbiota transplantation (FMT) combined with soluble dietary fiber and probiotics for slow transit constipation(STC).. Twenty-three patients with STC from Jinling Hospital, Medical School of Nanjing University were prospectively enrolled between April 2015 and January 2016. STC patients received FMT combined with soluble dietary fiber and probiotics. Fresh stool(100 g) was immediately mixed in a blender with 500 ml of 0.9% sterile saline for several seconds, which was then filtered through a gauze pad and a decreasing number of gauze screen (2.0 to 0.5 mm). The fecal bacteria suspension was stored frozen at -20centi-degree. The preparation time of FMT material was less than 1 hour. Total time of treatment was 9 days. An initial oral antibiotics(vancomycin 500 mg orally twice per day) was given for 3 consecutive days. Then the fecal microbiota(100 ml) was infused slowly(5 min) through nasojejunal tube for 6 consecutive days. After FMT, patients were recommended to receive soluble dietary fiber (pectin, 8 g/d) and probiotics (bifid triple viable capsules, twice per day) for 4 weeks. Rates of clinical improvement and remission, adverse events, constipation-related symptoms (PAC-SYM scores), bowel movements per week and gastrointestinal quality-of-life index (GIQLI) were recorded during the 12-week follow-up. This study was registered in the Clinical Trials.gov (NCT02016469).. FMT combined with soluble dietary fiber and probiotics is safe and effective in treating slow transit constipation, which can improve the symptom and quality of life significantly.

Topics: Adult; Aged; Constipation; Defecation; Dietary Fiber; Fecal Microbiota Transplantation; Feces; Female; Gastrointestinal Diseases; Humans; Male; Microbiota; Middle Aged; Pectins; Probiotics; Quality of Life; Treatment Outcome

The treatment method of disbios suffered by patients with syndrome of irritated intestines with constipations was under research. The method was based on introduction of sour-milk beverage with addition of beet pectin in a dietary intake. The comparison product was kefir. The following developments were detected against the positive dynamics of clinical symptoms: improvement of microbiocenosis structure, reduction of potentially pathogenic germs, inhibition of pathogenic properties of enterotoxigenic Staphylococcus aureus. Comparison group results showed lower clinical efficiency and poorer effect of dietary treatment on large gut microorganisms, contents of enterotoxigenic S. aureus remained unchanged. Introduction of sour-milk beverage with addition of alimentary fibre in a dietary intake of patients suffering the syndrome of irritated intestines with constipations was found expedient.

Topics: Adult; Constipation; Dairy Products; Dietary Supplements; Enterotoxins; Female; Food, Fortified; Humans; Intestinal Diseases; Intestine, Large; Middle Aged; Pectins; Staphylococcus aureus; Treatment Outcome

Topics: Cathartics; Cellulose; Cholesterol; Constipation; Dietary Fiber; Humans; Pectins

Topics: Adsorption; Cellulose; Constipation; Dietary Fiber; Diverticulum; Humans; Pectins

Topics: Arteriosclerosis; Cellulose; Cholesterol; Constipation; Coronary Disease; Diabetes Mellitus; Dietary Fiber; Humans; Obesity; Pectins

Topics: Absorption; Arteriosclerosis; Bile Acids and Salts; Cellulose; Cholelithiasis; Cholesterol; Colonic Neoplasms; Constipation; Deoxycholic Acid; Dietary Fiber; Humans; Hypercholesterolemia; Intestinal Absorption; Lipid Metabolism; Lithocholic Acid; Pectins; Water

Topics: Bile Acids and Salts; Cellulose; Cholelithiasis; Cholesterol; Colonic Neoplasms; Constipation; Diet; Digestion; Diverticulum, Colon; Feces; Feeding Behavior; Gastrointestinal Diseases; Humans; Hypercholesterolemia; In Vitro Techniques; Intestinal Absorption; Lignin; Metabolic Diseases; Pectins

Topics: Bread; Cellulose; Constipation; Diet; Feeding Behavior; Humans; Nutrition Assessment; Nutritional Status; Pectins