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Dried plums vs. psyllium: authors’ reply

cramps in over 30% of patients, and one may wonder whether even the small amounts contained in prunes may induce progressively more severe side effects in the long term. Third, prunes also contain large amounts of simple sugars with obvious metabolic effects that make them potentially harmful in a substantial proportion of elderly patients. Prunes may indeed represent a safe and effective remedy for chronic constipation in some cases, but physicians should be careful before uncritically adopting natural therapies that are not necessarily devoid of side effects. While waiting for indications from health authorities, physicians should consider substantial information about safety and efficacy in the short as well in the long term before recommending ‘grandma recipes’ to treat chronic pathological conditions. The article by Attaluri et al. is a step in the right direction, but a lot remains to be done.