Department of Nutritional Sciences, King's College London, London, UK.
Neurogastroenterol Motil. 2023 Nov;35(11):e14613. doi: 10.1111/nmo.14613. Epub 2023 May 27.
Over-the-counter supplements are commonly used to manage chronic constipation; however, their efficacy remains unclear. We aimed to investigate the effect of food, vitamin or mineral supplements 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-searching abstracts. RCTs reporting administration of food supplements (e.g., fruit extract supplements), vitamin or mineral supplements in adults with chronic constipation were included. Studies administering whole foods (e.g., fruits) were excluded. Risk of bias (RoB) was assessed with Cochrane RoB 2.0. Relative risks (RR), mean differences (MD), or standardized mean differences (95% confidence intervals [CI]) were calculated using a random-effects model.
Eight RCTs (787 participants) were included, investigating kiwifruit (n = 3 RCTs), senna (n = 2), magnesium oxide (n = 2), Ziziphus jujuba (n = 1), and Malva Sylvestris (n = 1) supplements. Kiwifruit supplements did not impact stool frequency (MD 0.24 bowel movements/week [-0.32, 0.80]; p = 0.40) or consistency (MD -0.11 Bristol points [-0.31, 0.09], p = 0.29). Overall, 61% responded to senna and 28% to control; however, this did not reach statistical significance (RR 2.78, [0.93, 8.27]; p = 0.07). Overall, 68% responded to magnesium oxide and 19% to control (RR 3.32 [1.59, 6.92]; p = 0.001). Magnesium oxide improved stool frequency (MD 3.72 bowel movements/week [1.41, 6.03]; p = 0.002) and consistency (MD 1.14 Bristol points [0.48, 1.79]; p = 0.0007).
Magnesium oxide supplements are effective at improving cardinal symptoms of chronic constipation. Senna and kiwifruit supplements did not impact symptoms; however, findings were based on a small number of studies. Further research is required to investigate the effect of food supplements (e.g., kiwifruit supplements), as well as their whole food equivalents (e.g., whole kiwifruits) in chronic constipation.
非处方补充剂常用于治疗慢性便秘；然而，其疗效仍不清楚。我们旨在通过系统评价和随机对照试验（RCT）的荟萃分析来研究食物、维生素或矿物质补充剂对慢性便秘成人的粪便排出量、肠道转运时间、症状和生活质量的影响。
使用电子数据库、回溯引文和手工检索摘要来确定研究。纳入了报告在慢性便秘成人中给予食物补充剂（例如，水果提取物补充剂）、维生素或矿物质补充剂的 RCT。给予全食物（例如，水果）的研究被排除在外。使用 Cochrane RoB 2.0 评估偏倚风险（RoB）。使用随机效应模型计算相对风险（RR）、均数差值（MD）或标准化均数差值（95%置信区间 [CI]）。
纳入了 8 项 RCT（787 名参与者），研究了奇异果（n=3 项 RCT）、番泻叶（n=2）、氧化镁（n=2）、酸枣（n=1）和锦葵（n=1）补充剂。奇异果补充剂对粪便频率（MD 0.24 次/周[-0.32，0.80]；p=0.40）或稠度（MD -0.11 布里斯托粪便分类点[-0.31，0.09]；p=0.29）没有影响。总的来说，61%的人对番泻叶有反应，28%的人对对照有反应；然而，这并没有达到统计学意义（RR 2.78，[0.93，8.27]；p=0.07）。总的来说，68%的人对氧化镁有反应，19%的人对对照有反应（RR 3.32 [1.59，6.92]；p=0.001）。氧化镁改善了粪便频率（MD 3.72 次/周[1.41，6.03]；p=0.002）和稠度（MD 1.14 布里斯托粪便分类点[0.48，1.79]；p=0.0007）。
氧化镁补充剂可有效改善慢性便秘的主要症状。番泻叶和奇异果补充剂对症状没有影响；然而，这些发现是基于少数研究。需要进一步研究食物补充剂（例如，奇异果补充剂）以及慢性便秘中的全食物等效物（例如，整个奇异果）的效果。
