Originally published on DoctorMurray.com.
How crazy is it that Americans spend over $2 billion a year on laxatives to deal with constipation? Here is something else to ponder, studies designed to determine the percentage of adults suffering from chronic constipation put the number between 24% to almost 50%.
Rather than relying on laxatives and stool softeners, people need to wake up and look first to foods to improve digestive health. An elaborate new study has added figs to a long list of effective foods to aid intestinal health and relieve constipation.
The fig tree is native to the Middle East and Mediterranean and is one of the world’s first cultivated trees. The fig tree can trace its history back to the earliest of times with mentions in the Bible (remember the fig leaf?) and other ancient writings. Figs are grown in moderate climates all over the world with the five leading world producers being Turkey, Greece, the U.S., Portugal, and Spain. Approximately 99% of the U.S. crop in grown in California.
Figs have a unique, sweet taste; a chewy texture to their flesh and skin; and a crunchiness to their seeds. Fresh figs are delicate and perishable, so most often figs are dried, either by exposure to sunlight or through an artificial process, creating a sweet and nutritious dried fruit that can be enjoyed throughout the year. Figs range dramatically in color and subtly in texture depending upon the variety, of which there are more than one hundred and fifty. Some of the most popular varieties are:
- Adriatic: the variety most often used to make fig bars, which has a light green skin and pink-tan flesh
- Black Mission: blackish-purple skin and pink colored flesh
- Kadota: green skin and purplish flesh
- Calimyrna: greenish-yellow skin and amber flesh
- Brown Turkey: purple skin and red flesh
Figs are high in natural simple sugars, minerals, fiber, and flavonoids.
Historically, figs have been recommended as a laxative as well as to nourish and tone the intestines. Animal studies have confirmed these benefits. After feeding rats or beagles fig paste for three to four weeks, researchers have observed increases in the production of the protective mucin that lines the intestines, as well as improved peristalsis (the intestinal contractions that propel the food bolus through the intestines). Fig consumption also shortened the time fecal material stayed in the colon, as well as increased the fecal quantity indicating a pronounced prebiotic effect.
To test the effects of figs as a laxative in humans with chronic constipation, a very elaborate study was conducted in Korea at the Clinical Trial Center for Functional Foods in the Chonbuk National University Hospital. In order to make the study double-blind, obviously figs could not be used because it would be impossible to make a placebo look just like a fig. So, the researchers made figs into a paste and also created a placebo paste out of flavoring agents, sugar and modified starch that had the same taste, smell and appearance as the fig paste.
Next, 40 subjects were selected who met the criteria of suffering from what is termed functional constipation. In functional constipation people experience reduced stool frequency (e.g., less than 3 bowel movements a week), hard stools, and difficulty or straining passing stools. Functional constipation is different from the irritable bowel syndrome (IBS) because it does not have the abdominal discomfort or pain, and a change in stool frequency or consistency characteristic of IBS.
The patients were then divided into two groups. One group got the fig paste that was equal to about 3 figs and the other got the placebo paste for 8 weeks. The primary outcome was colon transit time and secondary outcomes were based upon results from a questionnaire related to defecation.
The results were obvious and statistically significant in favor of the fig paste. In particular, there was a significant reduction in colon transit time and a significant improvement in stool type compared with the placebo. The colon transit time was reduced from 63 hours to 38 hours in the fig group. Stool consistency was improved (i.e., stools were softer) with fig paste consumption.
These results show that eating approximately 3 figs per day results in significant improvement in bowel function in patients suffering from chronic constipation.
The truth is that constipation will often respond to a high-fiber diet, plentiful fluid consumption, and exercise. This fact is well accepted and there is absolutely no argument from anyone in the medical community that focusing on these natural approaches should constitute the first step in the treatment of chronic constipation. Yet, we are purchasing $2 billion worth of laxatives each year? It just doesn’t make sense.
Especially important in relieving and preventing constipation is the recommendation of increasing dietary fiber. High levels of dietary fiber increases both the frequency and quantity of bowel movements, decreases the transit time of stools, decreases the absorption of toxins from the stool, and appears to be a preventive factor in several diseases. The recommended daily intake is 25-35 grams of fiber from dietary sources. However, higher amounts may be more optimal for health as our evolutionary diet contained approximately 100 grams of daily fiber. Most Americans only get about 10-15 grams of fiber each day, hardly enough to help propel food through our digestive tract and nourish the microbiome.
Baek HI, Ha KC, Kim HM, et al. Randomized, double-blind, placebo-controlled trial of Ficus carica paste for the management of functional constipation. Asia Pac J Clin Nutr. 2016;25(3):487-96.