Probiotics Improve Functional Constipation Symptoms in Adults

Probiotics can help relieve the symptoms of constipation, increasing bowel movement frequency and improving stool quality.

Two probiotic bacteria cocktails are effective at improving stool quality and frequency among adults with functional constipation, according to study findings published in Medicine.

Researchers conducted a single-center, parallel, randomized, double-blind, controlled trial (ClinicalTrials.gov Identifier: NCT04437147) enrolling 132 adults, ranging in age from 39.9 to 43.1 years, with functional constipation. Patients were randomly assigned to 3 groups and received 4 weeks of daily treatment and a follow-up 1 week after the last treatment.

The first group of 41 patients received a probiotic cocktail treatment containing 3 billion colony-forming units of mixed probiotic bacterial strains, including Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus rhamnosus.

The second group of 49 patients received a probiotic cocktail treatment containing 8 billion colony-forming units of mixed probiotic bacterial strains, including Lactobacillus acidophilus, Bifidobacterium bifidum, Lactobacillus rhamnosus, Lactobacillus paracasei, Bifidobacterium longum, Bifidobacterium lactis, Lactobacillus casei, and Bifidobacterium animallis.

Treatment with these probiotic cocktails was safe and well tolerated, with only one adverse event resulting in discontinuation.

The control group of 39 patients received conventional fiber treatment for constipation, including prebiotic fibers, vitamins, and minerals.

One week after 4 weeks of treatment, researchers did not observe any significant differences between the 3 treatment groups in bowel movement frequency or stool quality as measured by the Bristol stool form scale (BSFS; all P ≥.05). Stool frequency and quality in all 3 groups improved. This finding indicated that probiotics were not inferior to conventionally used treatments for functional constipation in terms of treatment success.

The only adverse event involved increased abdominal pain in one patient in the second group, suggesting that probiotics were largely well-tolerated in this patient population.

“[B]oth probiotic bacteria cocktails integrating either 3 LAB strains or 8 LAB strains improved the symptoms of intestinal functional constipation by increasing both the weekly frequency of evacuation and stool quality, as early as from the first week of treatment, with sustained improvements throughout the fourth week of treatment,” the study authors wrote. “Treatment with these probiotic cocktails was safe and well tolerated, with only one adverse event resulting in discontinuation.”

Study limitations include use of patient-reported symptoms as opposed to direct observation and lack of control using a placebo, which may have masked the efficacy of probiotics for the treatment of functional constipation.

References:

Mitelmão FCR, Häckel K, Bergamaschi C de C, et al. The effect of probiotics on functional constipation in adults: A randomized, double-blind controlled trial. Medicine. 2022;101(43):e31185. doi:10.1097/MD.0000000000031185