Effectiveness of probiotics on functional constipation symptoms in adults: an integrative review

Authors

Keywords:

constipation, microbiota, effectiveness, probiotics

Abstract

This integrative review of randomized clinical trials aimed to understand if probiotics are effective in relieve functional constipation in adults, and determine the best probiotic dose, species and duration of supplementation. The search strategy will include the following search terms with the Boolean operators: (functional constipation OR chronic constipation) AND (probiotics OR lactobacillus OR bifidobacterium OR Saccharomyces OR Streptococcus OR Enterococcus OR Bacillus coagulans OR Bacillus clausii OR lactococcus) in the following databases: EBSCO, ScienceDirect, Scientific Electronic Library Online, Biblioteca Virtual em Saúde and Cochrane Library. A total of 10 records were chosen. Bacillus coagulans Unique IS2 and Lactobacillus reuteri DSM 17938 appear to improve several parameters of constipation, such as sensation of incomplete evacuation, abdominal and defecation pain. Lactobacillus plantarum LRCC5193 appears to improve defecation consistency. Probiotics seems to have better effect against moderated to severe constipated populations, except those with longer gut transit time. In summary, the positive effect of probiotics seems directly related to longer supplementation time, type, dose and format of the strain. Adequately powered randomized clinical trials are needed.

Author Biographies

Mrs. Santucci, Pontifícia University Catholia of Campinas (PUC – Campinas)

Graduated in Nutrition from the State University of Campinas (2020). She completed a specialization in Women's Health, in the multidisciplinary residency modality, at the Pontifical Catholic University of Campinas. She has experience in the area of Nutrition, with an emphasis on oncological nutrition and women's health.

Alane Nogueira Bezerra, Universidade Estadual do Ceará

Possui graduação em Nutrição pela Universidade Estadual do Ceará (2012). É especialista em Nutrição Clínica e Funcional (2015) e em Prescrição de fitoterápicos e suplementação nutricional clínica e esportiva (2017). Diabetologista pela Residência Multiprofissional de Assistência em Diabetes pelo Hospital Universitário Walter Cantídio/UFC (2017) e Mestra em Nutrição e Saúde pela Universidade Estadual do Ceará (2015). Nutricionista Servidora Pública do município de São Gonçalo do Amarante - CE. Professora do Curso de Nutrição da Unifametro (2017- atual). Atua principalmente nos seguintes temas: saúde coletiva, doenças crônicas não transmissíveis, obesidade, doenças nutricionais.

References

AHIRE, J. J.; NEELAMRAJU, J.; MADEMPUDI, R. S. Behavior of Bacillus coagulans Unique IS2 spores during passage through the simulator of human intestinal microbial ecosystem (SHIME) model. LWT [Internet], v. 124, p. 109196, 2020. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0023643820301845.

AIRAKSINEN, K . et al. The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: a double blind, randomised, placebo controlled 2-week trial. Benef Microbes [Internet], v. 10, n. 6, p. 617–27, 2019. Disponível em: https://www.wageningenacademic.com/doi/10.3920/BM2018.0163

ALANDER, M. et al. Persistence of colonization of human colonic mucosa by a probiotic strain, Lactobacillus rhamnosus GG, after oral consumption. Appl Environ Microbiol [Internet], v. 65, n. 1, p. 351–4, 1999. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/9872808.

AZIZ, I. et al. An approach to the diagnosis and management of Rome IV functional disorders of chronic constipation. Expert Rev Gastroenterol Hepatol [Internet], v. 14, n. 1, p. 39–46, 2020. Disponível em: https://doi.org/10.1080/17474124.2020.1708718.

BEZERRA, C. C. R. Uso de biofeedback combinado com a dieta no tratamento da defecação obstruída associada à contração paradoxal do puborretal (anismus): fatores preditivos e resultados a curto prazo. Diss (Mestrado em Ciências Médico-Cirúrgicas) - Fac Med Univ Fed do Ceará, Fortaleza. 2019.

BLACK, C. J.; FORD, A. C. Chronic idiopathic constipation in adults: epidemiology, pathophysiology, diagnosis and clinical management. Med J Aust [Internet], v. 209, n. 2, p. 86–91. 2018. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/29996755.

BOTHE, G.; COH, A.; AUINGER, A. Efficacy and safety of a natural mineral water rich in magnesium and sulphate for bowel function: a double-blind, randomized, placebo-controlled study. Eur J Nutr., v. 56, n. 2, p. 491–9, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/26582579/.

DIMIDI, E. et al. Randomised clinical trial: Bifidobacterium lactis NCC2818 probiotic vs placebo, and impact on gut transit time, symptoms, and gut microbiology in chronic constipation. Aliment Pharmacol Ther [Internet], v. 49, n. 3, p. 251–64, 2019. Disponível em: https://onlinelibrary.wiley.com/doi/10.1111/apt.15073.

FINEOUT-OVERHOLT, E. et al. Evidence-based practice, step by step: Critical appraisal of the evidence: part III. Am J Nurs [Internet], v. 110, n. 11, p. 43–51, 2010. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/20980899.

HEIDELBAUGH, J. J. et al. The spectrum of constipation-predominant irritable bowel syndrome and chronic idiopathic constipation: US survey assessing symptoms, care seeking, and disease burden. Am J Gastroenterol [Internet], v. 110, n. 4, p. 580–7, 2015. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/25781368.

IBARRA, A. et al. Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: A double-blind, randomized, placebo-controlled, and dose-ranging trial. Gut Microbes [Internet]. v. 9, n. 3, p. 236–51, 2018. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/29227175.

KIM, E. R.; RHEE, P-L. How to interpret a functional or motility test - colon transit study. J Neurogastroenterol Motil [Internet], v. 18, n. 1, p. 94–9, 2012. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/22323993.

LIU, W. et al. Effects of Lactobacillus plantarum P9 Probiotics on Defecation and Quality of Life of Individuals with Chronic Constipation: Protocol for a Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Hashempur MH, organizador. Evidence-Based Complement Altern Med [Internet], v. 2022, p. 1–19, 2022. Disponível em: https://doi.org/10.1155/2022/4144321.

MADEMPUDI, R. S. et al. Bacillus coagulans Unique IS2 in Constipation: A Double-Blind, Placebo-Controlled Study. Probiotics Antimicrob Proteins [Internet]. v. 12, n. 2, p. 335–42, 2020. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/30911991.

MARTONI, C. J. et al. Impact of a probiotic product on bowel habits and microbial profile in participants with functional constipation: A randomized controlled trial. J Dig Dis [Internet], v. 20, n. 9, p. 435–46, 2019. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/31271261.

MILLER, L. E.; ZIMMERMANN, A. K.; OUWEHAND, A. C. Contemporary meta-analysis of short-term probiotic consumption on gastrointestinal transit. World J Gastroenterol [Internet], v. 22, n. 21, p. 5122–31, 2016. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/27275105.

MOREIRA, T. R.; LEONHARDT, D.; CONDE, S. R. Influence of drinking a probiotic fermented milk beverage containing bifidobacterium animalis on the symptoms of constipation. Arq Gastroenterol [Internet], v. 54, n. 3, p. 206–10, 2017. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032017000300206&lng=en&tlng=en.

OHKUSA, T.; KOIDO, S.; NISHIKAWA, Y.; SATO, N. Gut Microbiota and Chronic Constipation: A Review and Update. Front Med [Internet], v. 6, n. 19, 2019. Disponível em: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC6379309.

PAGE, M. J. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ [Internet], v. 372, p. n71, 2021. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/33782057.

RIEZZO, G. et al. Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation. Benef Microbes [Internet], v. 9, n. 1, p. 51–60, 2018. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/29022390.

SCHMULSON, M. J.; DROSSMAN, D. A. What Is New in Rome IV. J Neurogastroenterol Motil [Internet], v. 23, n. 2, p. 151–63, 2017. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/28274109.

SUMIDA, K. et al. Constipation and risk of death and cardiovascular events. Atherosclerosis [Internet], v. 281, p. 114–20, 2019. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0021915018315521.

TANIGUCHI, T. M.; ABREU, G. E.; PORTUGAL, M. M.; BARROSO JUNIOR, U. Cross-cultural adaptation and validation of the constipation scoring system for the brazilian population. Arq Gastroenterol [Internet], v. 59, n. 1, p. 3–8, 2022. Disponível em: https://doi.org/10.1590/S0004-2803.202200001-02.

VENKATARAMAN, R. et al. Effect of Bacillus coagulans Unique IS2 with Lactulose on Functional Constipation in Adults: a Double-Blind Placebo Controlled Study. Probiotics Antimicrob Proteins [Internet], v. 15, p. 379-386, 2021. Disponível em: https://link.springer.com/10.1007/s12602-021-09855-8.

WAITZBERG, D. L. et al. Effect of synbiotic in constipated adult women – A randomized, double-blind, placebo-controlled study of clinical response. Clin Nutr [Internet], v. 32, n. 1, p. 27–33, 2013. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S026156141200177X.

WALLER, P. A. et al. Dose-response effect of Bifidobacterium lactis HN019 on whole gut transit time and functional gastrointestinal symptoms in adults. Scand J Gastroenterol [Internet], v. 46, n. 9, p. 1057–64, 2011. Disponível em: http://www.ncbi.nlm.nih.gov/pubmed/21663486.

WANG, L. et al. Acetic acid and butyric acid released in large intestine play different roles in the alleviation of constipation. J Funct Foods [Internet], v. 69, p. 103953, 2020. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S1756464620301778.

WANG, R. et al. Effect of Bifidobacterium animalis subsp. lactis MN-Gup on constipation and the composition of gut microbiota. Benef Microbes [Internet], v. 12, n. 1, p. 31–42, 2021. Disponível em: https://www.wageningenacademic.com/doi/10.3920/BM2020.0023.

YOON, J. Y. et al. Probiotics Ameliorate Stool Consistency in Patients with Chronic Constipation: A Randomized, Double-Blind, Placebo-Controlled Study. Dig Dis Sci [Internet], v. 63, n. 10, p. 2754–64, 2018. Disponível em http://www.ncbi.nlm.nih.gov/pubmed/29876777.

ZHANG, C. et al. Meta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults. Clin Nutr [Internet], v. 39, n. 10, p. 2960–9, 2020. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0261561420300108.

Downloads

Published

2024-06-25

How to Cite

SANTUCCI, L. F.; BEZERRA, A. N. Effectiveness of probiotics on functional constipation symptoms in adults: an integrative review. Gestão & Cuidado em Saúde, Fortaleza, v. 2, n. 1, p. e12153, 2024. Disponível em: https://revistas.uece.br/index.php/gestaoecuidado/article/view/12153. Acesso em: 3 jul. 2024.

Issue

Volume 2

Section

Review Articles

Categories

License

Copyright (c) 2024 Leticia Foglia Santucci, Alane Nogueira Bezerra

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.