the subject, can disagree about almost anything.
Irritable Bowel Syndrome & The Great Prune Debate
News - August 9th, 2011 - Written by Gabriel -
A recent minor spat between the University of Iowa & the University of
Melbourne brings awareness to the roles that prunes, sorbitol &
FODMAPs play in Irritable Bowel Syndrome.
Prunes were the topic of discussion in a recent debate over their
effectiveness in treating Irritable Bowel Syndrome constipation. The
debate started over a bit of research done by the University of Iowa=92s
Department of Gastroenterology which suggested that prunes were
possibly a more effective treatment option than psyllium husks for
those with Irritable Bowel Syndrome constipation.
However not all were satisfied with methods or the results of this
research. Prof Peter Gibson and dietitian Emma Halmos of Monash
University in Melbourne wrote a retort to the journal =93Alimentary
Pharmacology and Therapeutics=94, which is the same journal the original
study appeared in. The retort suggested that the prune=92s laxative
effects were probably due to their large quantity of sorbitol, which
itself is used as a laxative when given in high enough of a dosage.
Sorbitol is essentially an indigestible sugar & is part of the
=93fermentable oligo-, di-, mono-saccharides and polyols=94 family aka
(FODMAPs) of which Prof Peter Gibson and dietitian Emma Halmos have
written extensively on. They suggested that too much sorbitol may
actually be detrimental to those with Irritable Bowel Syndrome,
possibly making their symptoms worse by contributing to bloating due
gas production from the fermentation of the indigestible sorbitol.
The study original authors wrote back suggesting that sorbitol was not
the reason for the positive benefits people received from taking the
prunes. They felt that the prune=92s fiber, polyphenols & other contents
played a larger part than the sorbitol. The response also closed with
somewhat of a jab at their detractors by suggesting that they were
being overzealous in their desire to make a connection between FODMAPs
& Irritable Bowel Syndrome.
My personal feelings are that it could go either way. I know that a
lot of people with & without Irritable Bowel Syndrome have issues with
sorbitol & other indigestible sugars. Some also have issues with
fibrous fruits & vegetables. There are some who can=92t handle psyllium
husk or prunes, especially those who seemingly have alternating
Irritable Bowel Syndrome symptoms. As usual it really depends on the
individual & that=92s probably the best thing a doctor can gain from
this at the moment until more research is done. Treatment should be on
an individual level & if something is not working for your patient or
making it worse, listen & don=92t be afraid to try something different.
Source: Irish Medical Times
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