Prune Juice is the Best Choice for Constipation
For adult patients with constipation, prune juice (or whole prunes) is the most effective juice option, demonstrating superior efficacy compared to other natural remedies including fiber supplements. 1
Evidence for Prune Juice
Prunes (dried plums) at 100g daily significantly increased complete spontaneous bowel movements per week and improved stool consistency more effectively than psyllium in a randomized controlled trial 1
Prunes were found to be safe, palatable, and more effective than psyllium for mild to moderate constipation, and should be considered as first-line therapy 1
In a comparative effectiveness trial, prunes (100g daily) significantly improved weekly complete spontaneous bowel movements, stool consistency, and straining compared to baseline 2
Why Not Other Juices?
The evidence base does not support other fruit juices for constipation management. While kiwifruit showed promise in one trial (with the lowest adverse event rate and patient dissatisfaction), this was whole fruit rather than juice 2. No high-quality evidence exists for apple juice, pear juice, or other commonly recommended juices.
Practical Implementation
Dose: 100g (approximately 4-5 prunes or equivalent juice) daily 1
Prunes provide approximately 6g of fiber per 100g serving 1
This can be used as monotherapy for mild constipation or combined with other laxatives for more severe cases 2
Prunes are well-tolerated with minimal adverse effects compared to medicinal laxatives 1
Important Caveats
Fiber-based interventions (including prune juice) require adequate fluid intake to be effective 3
For patients on opioids or with severe constipation, prune juice alone is insufficient—stimulant laxatives (senna, bisacodyl) or osmotic laxatives (polyethylene glycol) are required 3
Supplemental fiber like psyllium may worsen constipation in some patients and should not be the primary recommendation 3
Prunes work through both osmotic effects (sorbitol content) and fiber content, making them more effective than simple fruit juices 1