Kiwi as Constipation Treatment and New Chronic Constipation Guideline in the June Issue of AJ

The June issue of The American Journal of Gastroenterology (AJG) showcases new clinical science and reviews, offering valuable insights into gastrointestinal health. One of the significant topics covered in this issue is the management of chronic idiopathic constipation (CIC). This article highlights the newly published joint society guideline on the pharmacological management of CIC, along with the role of kiwifruit consumption in alleviating constipation and the effects of endoscopic gastroplasty on hepatic fibrosis in patients with nonalcoholic fatty liver disease (NAFLD). Additionally, this issue features various articles on other gastrointestinal conditions, providing a comprehensive resource for healthcare professionals and researchers in the field.

American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation

Chronic idiopathic constipation (CIC) is a common gastrointestinal disorder that can significantly impact an individual's quality of life. While nonpharmacological therapies, including dietary adjustments and behavioral modifications, are often the initial steps in managing CIC, pharmacological treatment becomes necessary in many cases. The American Gastroenterological Association (AGA) and the American College of Gastroenterology (ACG) have collaborated to develop a clinical practice guideline focusing on the pharmacological management of CIC in adults.

The guideline emphasizes the importance of a multidimensional approach to CIC management, taking into account individual patient factors and preferences. Nonpharmacological interventions such as dietary recommendations and behavioral changes are recommended as initial strategies. However, when these measures are insufficient, pharmacological options are available. Over-the-counter and prescription medications, such as polyethylene glycol (PEG), secretagogues, and prokinetic agents, are among the pharmacological treatment options discussed in the guideline. The evidence-based recommendations provided in this joint guideline aim to assist healthcare professionals in making informed decisions regarding the pharmacological management of CIC.

Consumption of 2 Green Kiwifruits Daily Improves Constipation and Abdominal Comfort—Results of an International Multicenter Randomized Controlled Trial

Kiwifruit, with its rich nutrient profile and high fiber content, has been gaining attention as a potential natural remedy for constipation. In a

randomized controlled trial conducted across multiple centers, researchers investigated the effectiveness of consuming two green kiwifruits daily compared to psyllium, a commonly recommended dietary fiber supplement, in relieving constipation and improving abdominal comfort.

The study found that participants who consumed kiwifruit experienced significant improvements in stool consistency, a reduction in constipation, and relief from associated symptoms such as indigestion/reflux and abdominal pain. While both kiwifruit and psyllium were effective in reducing symptoms of irritable bowel syndrome with constipation (IBS-C), only kiwifruit demonstrated additional benefits in functional constipation (FC) and FC with IBS-C. Kiwifruit consumption was associated with superior outcomes compared to psyllium, particularly in terms of stool consistency and straining.

The findings of this study highlight the potential of kiwifruit as a dietary intervention for individuals experiencing constipation. Incorporating two green kiwifruits into the daily diet may offer a natural and effective approach to manage constipation symptoms and improve abdominal comfort.

Regression of Hepatic Fibrosis After Endoscopic Gastric Plication in Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is a prevalent condition characterized by the accumulation of fat in the liver, often associated with obesity and metabolic disorders. Hepatic fibrosis, the excessive accumulation of scar tissue in the liver, is a serious consequence of NAFLD and a significant predictor of mortality in affected individuals. The June issue of AJG features a retrospective analysis that explores the impact of endoscopic gastric plication, a minimally invasive procedure, on hepatic fibrosis in patients with underlying NAFLD.

The analysis revealed a significant improvement in liver-related outcomes within 6-12 months after the endoscopic gastroplasty procedure. The findings suggest that endoscopic gastric plication is associated with regression of nonhistologic features of NAFLD/NASH, including hepatic fibrosis. This improvement in liver health is of great importance, as hepatic fibrosis is a critical factor contributing to the long-term prognosis of patients with NAFLD. Furthermore, the procedure also demonstrated a positive effect on insulin resistance, another crucial aspect of metabolic health.

The regression of hepatic fibrosis observed after endoscopic gastric plication offers promising prospects for the management of NAFLD-related liver damage. By addressing the underlying factors contributing to the progression of hepatic fibrosis, this minimally invasive procedure presents a potential therapeutic option for patients with NAFLD.

Other articles in the June issue of AJG

The June issue of AJG covers a wide range of topics in gastroenterology, providing valuable insights into various gastrointestinal conditions. Some of the other articles featured in this issue include research on Crohn's disease, hepatitis B and C, motility disorders, pancreatitis, eosinophilic esophagitis, and more. These articles contribute to the growing body of knowledge in the field and serve as a resource for healthcare professionals and researchers seeking the latest advancements and clinical observations.

Conclusion

The June issue of The American Journal of Gastroenterology offers a comprehensive exploration of gastrointestinal health, focusing on the management of chronic idiopathic constipation, the potential benefits of kiwifruit consumption, and the regression of hepatic fibrosis in NAFLD patients after endoscopic gastric plication. These articles, along with others in the issue, contribute to the understanding and advancement of gastroenterological research and clinical practice. Healthcare professionals, researchers, and individuals seeking insights into these topics will find this issue of AJG to be a valuable resource.

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