Efficacy of Synbiotics in Patients with Slow Transit Constipation: A Prospective Randomized Trial

Abstract

Synbiotic intake may efficiently restore the balance of gut microbiota and improve gastrointestinal functions. The aim of the study was to evaluate the efficacy of a synbiotic in patients with slow transit constipation. A total of 100 patients with slow transit constipation were randomized to receive either a synbiotic or placebo twice daily for 12 weeks. The primary efficacy endpoints were the clinical remission and improvement rates at weeks 4 and 12. Stool frequency and consistency, colonic transit time (CTT), evacuation and abdominal symptoms, patient assessment of constipation symptoms, gastrointestinal quality-of-life index scores, satisfaction scores, and adverse events were also monitored. The clinical remission rates reached 37.5% at week 4 and 45.8% at week 12 in the treatment group, compared to 13.3% at week 4 and 16.7% at week 12 in the placebo group (p < 0.01 for both comparisons). Over 12 weeks, 64.6% of the patients who received the synbiotic experienced clinical improvement, compared to 29.2% of the patients in the placebo group (p < 0.01). During the intervention period, patients who were treated with the synbiotic exhibited increased stool frequency, improved stool consistency, decreased CTT, and improved constipation-related symptoms. This randomized, placebo-controlled trial suggested that dietary supplementation with a synbiotic improved evacuation-parameters-associated symptoms and colonic motility in patients with slow transit constipation (STC).

Effects of Synbiotic Supplementation on Gut Functioning and Systemic Inflammation of Community-Dwelling Elders - Secondary Analyses From a Randomized Clinical Trial

“…The benefits of pro, pre or synbiotic supplementation are known as beneficial to gut functionality. Studies similar to ours, in any way, have shown that probiotic intake (which are related to synbiotic) is capable of improving constipation in general population; the benefits pointed by the studies included increasing in the colonic transit (30) ; improvement in evacuation frequency (31) ; improvement in stool consistency (32) , among others. The benefits of these substances seem to be more pronounced when planned to specific groups, such as the ones diagnosed as functional constipation (33) .…”

Effects of probiotic-containing products on stool frequency and intestinal transit in constipated adults: systematic review and meta-analysis of randomized controlled trials

“…Subjects were predominantly female, mean age ranged from 22-50 years, and mean body mass index ranged from 19-32 kg/m 2 ( Table 1 ). A total of 19 studies [ 19 - 36 , 38 ] with 20 comparisons contributed data for stool frequency and 8 studies [ 18 , 21 , 25 , 26 , 30 - 32 , 37 ] with 9 comparisons contributed data for ITT. Intestinal transit time was reported as total intestinal transit time using radiopaque markers in 3 studies, colonic transit time using radiopaque markers in 3 studies, whole gut transit time using radiopaque markers in 2 studies, and orocecal transit time using carmine red dye in 1 study.…”

Short-Term Daily Intake of Polydextrose Fiber Does Not Shorten Intestinal Transit Time in Constipated Adults: A Randomized Controlled Trial

“…That this study was unsuccessful may feasibly be due to subject heterogeneity in the most bothersome symptom. We used modified Rome III diagnostic criteria for chronic functional constipation as inclusion conditions, and to limit the severity to those with mild to moderate constipation a CCCS score of 8–20 was set, as used elsewhere [ 59 , 60 , 61 ]. At baseline, the groups were well balanced, although compared to the placebo group, the 12 g/day dose polydextrose group had a slightly higher, albeit statistically non-significant, age (median 47 year vs. placebo 31 year, p = 0.11) and slightly lower daily intake of fiber (14.2 vs. placebo 15.3 g/day, p = 0.052).…”