The Effect of Probiotic Yogurt on Constipation in Pregnant Women: A Randomized Controlled Clinical Trial

Abstract

BackgroundProbiotics can alter the colonic microbiota and might improve bowel function.ObjectivesThe aim of this study was to evaluate the effect of the consumption of yogurt, enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 (CFU) on the symptoms of constipated pregnant women.Materials and MethodsThis triple-blind randomized controlled trial was conducted on 60 constipated pregnant women who were diagnosed by the ROME III criteria in Tabriz, Iran from December 2014 to July 2015. Participants were randomly put into two groups including the treatment and the control group through block randomization. The treatment group received 300 g of yogurt enriched with Bifidobacterium and Lactobacillus 4.8 × 1010 colony forming units (CFU) (n = 30) while the control group received conventional yogurt (n = 30) for 4 weeks. The defecation frequency, stool consistency, straining during defecation, sensation of anorectal obstruction, sensation of incomplete evacuation and manual manoeuvres to facilitate defecation were primary outcomes while the amount of defecation, stool colure, and quality of life were secondary outcomes.ResultsThe frequency of defecation was increased from 2.1 (0.8) at baseline to 8.3 (4.4) in the probiotic yogurt group vs. 2.3 (0.7) at baseline to 8.1 (4.3) in the conventional yogurt group at the end of 4th week. These results were based on the repeated measure ANOVA test and there was no statistically significant difference between the two groups (mean difference: 0.1; Confidence Interval 95%: -1.4 to 1.7; P = 0.872). Constipation symptoms including straining, anorectal obstruction, manipulation to facilitate defecation, consistency of stool and color of stool were improved significantly (P < 0.05) in both groups. In addition, the amount of defecation was significantly increased in both groups (P < 0.05), while incomplete evacuation was significantly reduced in the treatment group (P = 0.01). There was no statistically significant difference between the groups in the mean scores of physical (P = 0.726) and mental (P = 0.678) aspects of quality of life after the intervention with the adjusting of baseline scores.ConclusionsConsumption of 300 g/day probiotic and conventional yogurt can play a role in improving the symptoms of constipation during pregnancy.

Systematic review: probiotics in the management of lower gastrointestinal symptoms – an updated evidence‐based international consensus

“…The third study did not provide a between‐group statistical analysis; however, the decrease in constipation frequency score was approximately twofold greater in the probiotic groups than in the placebo group . Four studies reported no significant effect of 4 different probiotic treatments; however, 1 of these studies showed a nonsignificant trend in favour of probiotics . Of the 7 studies, 5 had been published since the original consensus.…”

“…After applying inclusion and exclusion criteria, 33 RCTs that reported on the effects of probiotics in the management of lower GI symptoms in clinical practice published since January 2012 were identified, and considered in conjunction with 37 RCTs included in the original systematic review. Of the 33, 6 publications were found in the June 2017 update . These could not be included in the consensus voting process; however, they were reviewed by the Steering Committee, which decided that the new evidence provided in these studies would not alter the results of the Delphi consensus and so could be included in our publication.…”

“…The majority of the 70 studies (Table S1) focused on IBS (based on Rome I, II or III criteria or physician diagnosis; 34 studies), antibiotic‐associated diarrhoea (13 studies) or diarrhoea‐associated Helicobacter pylori eradication therapy (7 studies). Other conditions were investigated in 16 studies.…”

“…Eleven studies examining 10 different probiotic treatments assessed bowel habit in indications other than IBS. Of these, 8 studies of 8 different probiotics reported that probiotics produced significant improvements in measures of bowel habit vs placebo, whereas 3 reported no difference between 3 different probiotics and placebo . Of the 11 studies, 7 had been published since the original consensus.…”

“…The majority of studies revealed no meaningful treatment‐emergent adverse events that were attributed to probiotic use. Forty‐three studies found no relevant differences in safety between 37 specific probiotic treatments and placebo . Findings of the remaining 7 studies (examining 7 probiotic strains) are summarised below.…”