The Effect of Probiotics on Childhood Constipation: A Randomized Controlled Double Blind Clinical Trial

Abstract

Background. Inconsistent data exist about the role of probiotics in the treatment of constipated children. The aim of this study was to investigate the effectiveness of probiotics in childhood constipation. Materials and Methods. In this placebo controlled trial, fifty-six children aged 4–12 years with constipation received randomly lactulose plus Protexin or lactulose plus placebo daily for four weeks. Stool frequency and consistency, abdominal pain, fecal incontinence, and weight gain were studied at the beginning, after the first week, and at the end of the 4th week in both groups. Results. Forty-eight patients completed the study. At the end of the fourth week, the frequency and consistency of defecation improved significantly (P = 0.042 and P = 0.049, resp.). At the end of the first week, fecal incontinence and abdominal pain improved significantly in intervention group (P = 0.030 and P = 0.017, resp.) but, at the end of the fourth week, this difference was not significant (P = 0.125 and P = 0.161, resp.). A significant weight gain was observed at the end of the 1st week in the treatment group. Conclusion. This study showed that probiotics had a positive role in increasing the frequency and improving the consistency at the end of 4th week.

Gut Microbiota and the Use of Probiotics in Constipation in Children and Adolescents: Systematic Review

“…Of these, 12 articles that studied children and adolescents were included in this review. 8,9,13,[15][16][17][18][19][20][21][22][23] According to their content, the articles were divided into two categories: evaluation of the relationship between fecal microbiota and constipation; and the use of probiotics in the treatment of functional constipation. Figure 1 shows the study's flowchart.…”

“…The use of probiotics in the treatment of functional constipation has been evaluated in eight articles, [16][17][18][19][20][21][22][23] which were performed in Italy, 16,17 Poland, 18,19 Holland and Poland, 20 Taiwan, 21 Brazil 22 and Iran. 23 The main features of the studies are shown in Table 2.…”

“…The probiotic strains used for the intervention were predominantly from the genera Bifidobacterium and Lactobacillus: B. lactis DN-173010, 20 B. longum, 22 L. reuteri DSM 17938, 16 L. casei rhamnosus Lcr35, 19,21 LGG ATCC 531032, 18 23 Of these articles, only one found a higher frequency of probiotic therapeutic success in the treatment of constipation with statistical significance, using the strain Lactobacillus casei rhamnosus Lcr35. 21 Higher bowel movement frequency, 16,21,23 improved stool consistency, 21,23 reduced abdominal pain, 21 reduced pain during bowel movements 22 and flatulence reduction were observed. 20 The main results are shown in Table 3.…”

“…16,22,23 As can be seen from Table 2, three studies performed interventions with a laxative-associated probiotic: polyethylene glycol 17 and lactulose. 18,23 However, these medications are, by themselves, effective therapeutic interventions for the treatment of constipation 1,4,5 and their association with probiotics can be important to note, because the therapeutic role of probiotics may be covered up. Furthermore, it was difficult to compare studies in relation to the duration of constipation and the use of laxatives, which may interfere with the success of treatment with probiotics.…”

Effect of probiotics on constipation in children

“…There was a significant improvement in fecal incontinence and abdominal pain in the Group A, and at the end of the fourth week, this difference was not significant and there was improvement significantly in weight gain. Side effects were not seen in the during the treatment, Sadeghzadeh M et al 7 Inconsistent data exist about the role of probiotics in the treatment of constipated children. The aim of this study was to investigate the effectiveness of probiotics in childhood constipation.…”