A comparison between the effect of plums (prunes) and magnesium hydroxide on the constipation of cerebrovascular accident patients: A randomized clinical trial

authors:

avatar Mitra Khorrami , avatar Masoumeh Bagheri-Nesami ORCID , * , avatar Hooshang Akbari , avatar Nouraddin Mousavinasab , avatar Assie Jokar


how to cite: Khorrami M, Bagheri-Nesami M, Akbari H, Mousavinasab N, Jokar A. A comparison between the effect of plums (prunes) and magnesium hydroxide on the constipation of cerebrovascular accident patients: A randomized clinical trial. koomesh. 2020;22(1):e153147. 

Abstract

Introduction: A wide range of intensive care patients are constipated. It seems that dried plum is effective in acute constipation. Thus, the present study aimed to compare the effect of dried plums (prunes) with magnesium hydroxide on the constipation management of cerebrovascular accident patients hospitalized in the intensive care unit. Materials and Methods: This randomized controlled clinical trial has been performed on 24 patients with stroke admitted to the intensive care unit, suffering from constipation. In this way, for two days and twice each day by gavage, the interventional and control groups received 50 gr of dried plums in the form of syrup and 30 ml of magnesium hydroxide, respectively. Frequency of bowel movements and stool consistency of patients in both groups were recorded, and the Bristol stool scale was used to describe the stool consistency. Results: The mean and the standard deviation values of bowel movement in intervention and control groups were evaluated 0.281±0.56 and 0.309±0.22, respectively. The frequency stool consistency of normal in intervention group was %72.72 and in control group was %54.54. The comparison between the intervention and control groups demonstrated that there was not a significant variation in frequency of bowel movement and stool consistency. Conclusion: Results showed that plum is effective in increasing the number of bowel movement and stool consistency of stroke patients admitted to the intensive care unit, but no significant difference has been observed comparing with the group received magnesium hydroxide (control group).

References

  • 1.

    Guerra TLdS, Mendona SS, Marshall NG. Incidence of constipation in an intensive care unit. Rev Bras Ter Intensiva 2013; 25: 87-92. [DOI:10.5935/0103-507X.20130018]##2.

  • 2.

    Ghoshal UC, Gwee KA, Chen M, Gong XR, Pratap N, Hou X, et al. Development, translation and validation of enhanced asian Rome III questionnaires for diagnosis of functional bowel diseases in major asian languages: a rome foundation-asian neurogastroenterology and motility association working team report. J Neurogastroenterol Motil 2015; 21: 83-92. [DOI:10.5056/jnm14045]##4.

  • 3.

    Yi JH, Chun MH, Kim BR, Han EY, Park JY. Bowel function in acute stroke patients. Ann Rehabil Med 2011; 35: 337-343. [DOI:10.5535/arm.2011.35.3.337]##5.

  • 4.

    Harari D, Norton C, Lockwood L, Swift C. Treatment of constipation and fecal incontinence in stroke patients: randomized controlled trial. Stroke 2004; 35: 2549-2555. [DOI:10.1161/01.STR.0000144684.46826.62]##6.

  • 5.

    Hinkle JL, Cheever KH. Clinical Handbook for Brunner & Suddarth's Textbook of Medical-Surgical Nursing: Lippincott Williams & Wilkins; 2013.##7.

  • 6.

    Spodniewska E, Guha A. Constipation in critically ill patients and its relationship to feeding and weaning from respiratory support. Crit Care 2013;17: P241. [DOI:10.1186/cc12179]##8.

  • 7.

    Gacouin A, Camus C, Gros A, Isslame S, Marque S, Lavou S, et al. Constipation in long-term ventilated patients: associated factors and impact on intensive care unit outcomes. Crit Care Med 2010; 38: 1933-1938. [DOI:10.1097/CCM.0b013e3181eb9236]##9.

  • 8.

    HomayoonyRad A, Ha S. The effect of probiotics in the prevention and treatment of gastrointestinal diseases. Sci Magazine-Islamic Azad Univ Microbial Biotechnol Res 2010; 2: 53-60.##10.

  • 9.

    Lindeman RD, Romero LJ, Liang HC, Baumgartner RN, Koehler KM, Garry PJ. Do elderly persons need to be encouraged to drink more fluids? J Gerontol A Biol Sci Med Sci 2000; 55: M361-M365. [DOI:10.1093/gerona/55.7.M361]##11.

  • 10.

    Omidvary A. Dealing with annoying gases, effective treatment of flatulence. New J Medicine 1388; 451: 500-502. (Persian).##12.

  • 11.

    Ebrahimi Daryani N, Mirvaliani AF, Karamaty M. An overview of the diagnosis and treatment of constipation. Iran Med Council J 2010; 27: 362-379. (Persian).##13.

  • 12.

    Gang LI YW, Junhua Zheng, Bin Xu, Yang Zhuang, Zhongmin GU, jie Ling, Wei Qiu. Effect of biofeedback therapy for functional constipation in elderly patients. Chinese J Geriarics 2017; 36: 1318-1322.##14.

  • 13.

    Meisel J, Bergman D, Graney D, Saunders D, Rubin C. Human rectal mucosa: proctoscopic and morphological changes caused by laxatives. Gastroenterology 1977; 72: 1274-1279.##15.

  • 14.

    Jahangiri S, Tadayonfar M, Rahmani A, Rakhshani M. The effect of probiotic supplement to reduce abdominal bloating in stroke patients admitted to the ICU. Alborz Univ Med J 2016; 5: 218-222. (Persian). [DOI:10.18869/acadpub.aums.5.4.218]##16.

  • 15.

    Yang J, Wang HP, Zhou L, Xu CF. Effect of dietary fiber on constipation: a meta analysis. World J Gastroenterol 2012; 18: 7378-7383. [DOI:10.3748/wjg.v18.i48.7378]##17.

  • 16.

    Stacewicz-Sapuntzakis M. Dried plums and their products: composition and health effects--an updated review. Crit Rev Food Sci Nutr 2013; 53: 1277-1302. [DOI:10.1080/10408398.2011.563880]##18.

  • 17.

    Roshanaii Y, Amini E. Generic drugs: comprehensive information on Iranian and world drugs. editions T, editor. Tehran: Roshan Book 2015. (Persian).##19.

  • 18.

    Zakir MI. The book of goling. center for traditional medicine and medical mentors of Shahid Beheshti university. Tehran 2006; 92-97. (Persian).##20.

  • 19.

    Taghilo H, Edalat A. Baghbani omomi. 5th, editor. Tehran: Avaye nor; 2010. 318 p.##21.

  • 20.

    Zargaran A, Mehdizadeh A, Zarshenas MM, Mohagheghzadeh A. Avicenna (980-1037 AD). J Neurol 2012; 259: 389-390. [DOI:10.1007/s00415-011-6219-2]##22.

  • 21.

    Attaluri A, Donahoe R, Valestin J, Brown K, Rao SS. Randomised clinical trial: dried plums (prunes) vs. psyllium for constipation. Aliment Pharmacol Ther 2011; 33: 822-828. [DOI:10.1111/j.1365-2036.2011.04594.x]##23.

  • 22.

    Yao C, Tan HL, Langenberg D, Barrett J, Rose R, Liels K, et al. Dietary sorbitol and mannitol: food content and distinct absorption patterns between healthy individuals and patients with irritable bowel syndrome. J Hum Nutr Diet 2014; 27: 263-275. [DOI:10.1111/jhn.12144]##24.

  • 23.

    Lever E, Cole J, Scott S, Emery P, Whelan K. Systematic review: the effect of prunes on gastrointestinal function. Aliment Pharmacol Ther 2014; 40: 750-758. [DOI:10.1111/apt.12913]##25.

  • 24.

    Aghili m. makhzanoladvieh. 7th, editor. Tehran: Sabzarang; 2014. 147 p.##26.

  • 25.

    Kasper D HS, Jameson j, Fauci A, Lango D, Loscalzo J. Harrisons principles of internal medicine. 19ed. McGraw-Hill Medical Publishing Division. 2015##27.

  • 26.

    Adibi P, Behzad E, Pirzadeh S, Mohseni M. Bowel habit reference values and abnormalities in young Iranian healthy adults. Dig Dis Sci 2007; 52: 1810-1813. [DOI:10.1007/s10620-006-9509-2]##28.

  • 27.

    Chumpitazi BP, Self MM, Czyzewski DI, Cejka S, Swank PR, Shulman RJ. Bristol Stool Form Scale reliability and agreement decreases when determining Rome III stool form designations. Neurogastroenterol Motil 2016; 28: 443-448. [DOI:10.1111/nmo.12738]##29.

  • 28.

    Gomes PB, Duarte MA, Melo Mdo C. Comparison of the effectiveness of polyethylene glycol 4000 without electrolytes and magnesium hydroxide in the treatment of chronic functional constipation in children. J Pediatr (Rio J). 2011; 87: 24-28. [DOI:10.2223/JPED.2051]##30.

  • 29.

    Ye BD. [Effect of combination pretreatment of polyethylene glycol solution and magnesium hydroxide for colonoscopy]. Korean J Gastroenterol 2010; 55: 270-272. [DOI:10.4166/kjg.2010.55.4.270]##31.

  • 30.

    Saneian H, Mostofizadeh N. Comparing the efficacy of polyethylene glycol (PEG), magnesium hydroxide and lactulose in treatment of functional constipation in children. J Res Med Sci 2012; 17: 145-149.##32.

  • 31.

    Pasalar M, Bagheri Lankarani K, Mehrabani D, Tolidei H, Naseri M. The effect of descureania Sophia L. and prunus domestica L. in prevention of constipation among Iranian Hajj pilgrims, Saudi Arabia. Res J Pharm Biol Chem Sci 2013; 4: 1195-1204.##33.

  • 32.

    Sairanen U, Piirainen L, Nevala R, Korpela R. Yoghurt containing galacto-oligosaccharides, prunes and linseed reduces the severity of mild constipation in elderly subjects. Eur J Clin Nutr 2007; 61: 1423-1428. [DOI:10.1038/sj.ejcn.1602670].