Probiotics: A Possible Remedy For Constipation

Summary
This study was conducted to look into the effectiveness and tolerability of various probiotic preparations for relief from constipation. Probiotics are live bacteria or per the study, “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” Results from analysis of five different studies showed that in adults and children, some probiotic preparations increased the frequency of bowel movements and improved the consistency of stools.  Not all preparations were found to be useful. The authors conclude that the use of probiotics in constipation should be studied further.

Introduction
Constipation is a common condition affecting children and adults and in a large number of sufferers there is no specific cause for constipation. The current treatment of these cases is manual disimpaction at a doctor’s office, sometimes under sedation, and the use of laxatives. Although these drugs are safe and effective for many, some patients with no specific cause for constipation fail to respond to these therapies. Probiotics are live bacterial preparations that are used to treat certain gastrointestinal disorders including constipation and diarrhea. There have been a variety of studies on the benefits of these agents but there has been no consensus reached regarding their effectiveness. This study was undertaken to look into the benefits of these agents in constipation without specific cause from a number of different smaller studies.

Methodology

  • The researchers searched medical databases like MEDLINE, EMBASE, CINAHL and the Cochrane Library in May 2009, for studies on the use of probiotic preparations in constipation.
  • A total of five different studies, involving 377 patients, were included. Three of these were on adults and two on children.
  • In the studies, the patients were divided into two groups. The study group received probiotic preparations of various compositions for several days while the control patients received a placebo or no therapy.

Results

  • In the three studies conducted in adults, results showed that effective probiotic preparations included organisms like Bifidobacterium lactis DN-173 010, Lactobacillus casei Shirota, and E. coli Nissle 1917.
  • In the two studies conducted on children with constipation, a probiotic preparation containing L. casei rhamnosus Lcr35 was beneficial, but a preparation containingL. rhamnosus GG was not found helpful.
  • All studies showed good tolerability to the probiotic preparations, with no side effects.
  • However, in general, the data regarding efficacy of probiotics was not enough to strongly recommend its use.

Next steps/shortcomings
The authors agree that it is possible that some studies supported by probiotic manufacturers and that produced negative results, may have been unpublished and therefore not included in the databases researched for this study. Also some studies written in different languages, like Japanese, were left out of the evaluation. The authors also admit that many of the studies showed benefits or no benefits in a specific population of patients, but may not work on all people with constipation. Further studies addressing these shortcomings may be warranted to understand the role of probiotics in constipation.

Conclusion
This review of previous research studies shows that probiotics were useful to a certain extent in relieving constipation in the subjects studied. However, the facts are too few to translate into a definite conclusion regarding the use of probiotics. The authors conclude that “this systematic review demonstrates that the data published to date do not yet provide sufficient scientific evidence to support a general recommendation about the use of probiotics in the treatment of functional constipation.” The authors warn that until more concrete results showing benefits of these preparations in constipation are available, clinicians should consider the use of these probiotics in constipation as tentative. This review also raises more questions and helps to clarify available treatment options and stimulate new and better research.

For More Information:
Systematic Review of Probiotics for Functional Constipation
Publication Journal: World Journal of Gastroenterology, January 2010
By Anna Chmielewska; Hania Szajewska; Medical University of Warsaw, Poland

*FYI Living Lab Reports Are Summaries of the Original Research.

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