| |
| Date: 12-31-2018 | HC# 121831-607 |
Pourmasoumi
M, Ghiasvand R, Darvishi L, Hadi A, Bahreini N, Keshavarzpour Z. Comparison and
assessment of flixweed and fig effects on irritable bowel syndrome with
predominant constipation: A single-blind randomized clinical trial. [published
September 11, 2018]. Explore. doi: 10.1016/j.explore.2018.09.003.
Individuals with irritable
bowel syndrome (IBS) have bloating and abdominal pain or discomfort that can
cause them to miss work, increase their spending on health care, and experience
decreased quality of life. Constipation-predominant IBS (IBS-C) is defined as
constipation accompanied by abdominal pain, which is usually relieved by a
bowel movement. Flixweed (Descurainia
sophia, Brassicaceae) and
fig (Ficus carica, Moraceae) are rich in soluble
and insoluble fiber. They have a long history of traditional use for
constipation and other gastrointestinal problems. These authors conducted a single-blind, randomized, clinical trial to
examine the effects of flixweed and fig on the symptoms of IBS-C and on the
inflammation marker C-reactive protein (CRP).
Patients aged 18 to 70 years who were
referred to the gastrointestinal research center of Isfahan University of
Medical Sciences or to private medical practices in Isfahan, Iran, and were
diagnosed with IBS-C were eligible for the study. The 150 patients chosen for
the study were randomly and equally assigned to a flixweed, fig, or control
group for the four-month intervention study. According to group assignment, the
patients took 30 grams of dried flixweed or 45 grams of dried fig before
breakfast and before lunch with one glass of water daily or continued with
their normal diet in the control group. Anthropometric indices were measured at
baseline and at the end of the study. Dietary intake and physical activity were
evaluated, and all patients were monitored for any adverse effects during the
study.
The authors used the IBS Severity Score
System (IBSSS) at baseline and at the end of the study to assess abdominal
pain, frequency of abdominal pain, severity of abdominal distention,
dissatisfaction with bowel movements, and interference of IBS with life in
general. Total scores were rated as mild, moderate, or severe, with higher
scores indicating greater severity. The Bristol Stool Chart was used to
determine the frequency of bowel movements and hard stools. The effects of IBS
on quality of life were measured by examining the patients' answers to 34
questions about dysphoria, interference with activity, body image, health
concerns, food avoidance, social reactions, sexual concerns, and relationships.
Higher scores indicated better quality of life.
Of the 50 patients in the flixweed group, one
patient lost interest in completing the study, and one patient withdrew because
of influenza. In the fig group, one patient did not consume the fig product as instructed,
and three patients were not interested in completing the study. In the control
group, one patient moved, and one patient did not want to complete the study.
The number of patients completing the study totaled 142, with 48 each in the
flixweed and control groups and 46 in the fig group. No adverse effects were
reported during the study.
At baseline, the mean age of the patients was
57.56 ± 6.23 years; 75% of the patients were females, and 65% had moderately severe IBS. The three groups were similar
in dietary intake, physical activity, or anthropometric measures at baseline and
at the end of the study.
The authors report that total IBSSS scores
significantly improved in the flixweed and fig groups compared with baseline
and with the control group (P<0.05). All individual items, except for
abdominal pain severity, significantly improved in both the fig and flixweed
groups compared with baseline and with the control group at the end of the
study (P<0.05). Although abdominal pain severity improved in both the
flixweed and fig groups compared with baseline, the improvement was not statistically
significant. Improvements in defecation and hard stool frequency in both
intervention groups were significant compared with the control group
(P<0.05). Overall quality of life significantly improved in both
intervention groups after four months compared with baseline and with the
control group (P<0.05). Comparing the improvements observed in the fig and
flixweed groups, no significant differences were found in overall IBSSS score,
IBS symptoms, or quality of life. CRP levels did not significantly change in
any of the three groups.
Limitations of this study include the lack of
a placebo group, the use of only CRP as a marker of inflammation, and the focus
only on the fiber component of fig and flixweed and how it affected IBS-C
symptoms.
The authors conclude that these study results
"suggested that consumption of flixweed and fig among IBS-C patients may
have positive effects on IBS-C symptoms,
and that these natural products could be considered as a safe therapy for this
syndrome."
—Shari
Henson
