Comparison and Assessment of Flixweed and Fig Effects on Irritable Bowel Syndrome with Predominant Constipation: A Single-Blind Randomized Clinical Trial (original) (raw)
Background
Irritable bowel syndrome with predominant constipation (IBS-C) is a common digestive disorder. The current therapy is inadequate and evidence regarding the effect of herbal therapies on the relief of affected individuals is insufficient. The aim of this study was to investigate the beneficial effects of flixweed and fig consumption on IBS-C symptoms.
Methods
150 patients with IBS-C were enrolled in this randomized, controlled trial. All patients were randomly assigned to three groups and received an intervention for four months. The IBS severity score system and quality-of-life questionnaires were used for evaluating IBS-C symptoms. C-reactive protein levels, frequency of defecation and hard stool were also assessed.
Results
Consumption of flixweed or fig, compared to a control group, caused a significant improvement in IBS symptoms including frequency of pain, distention, frequency of defecation and hard stool. Also, the findings showed a significant increase in quality of life, as well as satisfaction with overall bowel habits. However, flixweed and fig intake had no significant effects on abdominal pain severity and C-reactive protein levels.
Conclusions
In conclusion, consumption of flixweed or fig for four months would be a useful therapy for alleviating IBS-C symptoms and can be a beneficial option for first-line treatment.
Introduction
Irritable Bowel Syndrome (IBS) is one of the most common functional gastrointestinal disorders, with a prevalence of 5–20%, depending on the diagnostic criteria selected.1, 2 IBS is characterized by bloating and abdominal pain or discomfort associated with changes in bowel habits in the absence of any specific mechanical, biochemical or inflammatory conditions.3 Although this syndrome does not lead to mortality, it decreases productivity through work absence, increases healthcare costs, and has a substantial negative effect on patient quality of life.4 Based on its symptoms, IBS is classified into three groups: diarrhea-predominant (IBS-D); constipation-predominant (IBS-C); and mixed type with diarrhea and constipation (IBS-M).5 Of these types, IBS-C affects about 34% of patients and is generally defined by constipation associated with abdominal pain, which is generally relieved by defecation.6 The pathology of this syndrome has not yet been clearly understood,7 although there are some suggested mechanisms for IBS causation, including impaired gastrointestinal motility, visceral hypersensitivity, low-grade mucosal inflammation, and dysfunctions of the brain-bowel axis.8 It has been shown that digestive organ dysfunction is mostly due to modifications in dietary habits. In this regard, plants and herbs have been reported as showing desirable effects, even playing an important role in the efficacy of pharmacological treatment.9
Descurainia Sophia (Flixweed) is an annual dicot, which has long been used in traditional medicine to relieve various conditions.10 Different components, such as lipids, flavonoids, lignin, phytosterol and cardiac glycosides have been identified from this seed.11 Also, it contains mucilage, which accounts for its laxative effects; thus flixweed can be beneficial for constipation.12
Ficus carica (Fig) has long been appreciated as a healthy food, and for its medicinal properties.13 This fruit is a good source of bioactive compounds with an antioxidant, anti-inflammatory and antimicrobial effect.14 Also, it contains high amounts of fiber, and is useful as a natural laxative.15
Both flixweed and fig are widely used as traditional treatments for gastrointestinal disorders and constipation.16, 17 However, to the best of the authors’ knowledge, there are no studies related to the effect of flixweed and fig consumption on symptom control in patients with IBS-C. Therefore, this study was conducted to examine the effect of flixweed and fig intake on abdominal pain, discomfort or cramps, defecation, hard stool, incomplete bowel movement and C-reactive protein blood levels among IBS patients.
Section snippets
Setting
The study was a 4-month, single-blind, randomized, controlled trial. The study protocol was approved by the Ethics Committee of Isfahan University of Medical Sciences (N: IR.MUI.REC.1394.3.197). Also, it was carried out based on the CONSORT statement recommendation, and registered on the clinicaltrial.gov website (ID: NCT02559245).
Subjects
Participants were selected from patients aged 18–70 who were referred to the gastrointestinal (GI) research center of Isfahan University of Medical Sciences and
Results
A total of 150 patients with IBS-C were enrolled and randomly assigned into three groups. Among individuals in group D, two patients [not interested in completing the study (n = 1), influenza (n = 1)] withdrew. In group F, four subjects [did not consume fig according to schedule (n = 1), not interested in completing the study (n = 3)] dropped out, while in group C, two people [migration (n = 1), not interested in completing study (n = 1)] were excluded. Finally, 142 participants completed the
Discussion
The present study indicates that supplementation for IBS-C patients with flixweed or fig for 4 months has a significantly beneficial effect on IBS-C symptom severity and on patients’ quality of life, compared to a control group who consumed their usual diet. These findings support the general notion that dried flixweed or fig, which are widely consumed, can be useful in alleviating IBS-C symptoms. However, this study failed to reveal any significant effect on the reduction of abdominal pain
Conclusion
In conclusion, the current study's findings 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. However, more studies with high-quality design are suggested.
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2023, Arabian Journal of Chemistry
Consumption of fruits (90 g/day) produces a significant improvement in the irritable bowel syndrome symptoms such as pain frequency, distention, frequency of defecation and hard stool in patients. The treatment is given for 120 days (Pourmasoumi et al., 2019). Melfi cream (F. carica aqueous extract of sun-dried fruit and base cream; topical use) significantly increases efficacy in terms of reducing the SCORAD index, pruritus, and intensity scores when compared to hydrocortisone (1.0%; P < 0.05; Abbasi et al., 2017).
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