Probiotics supplementation offers no help in functional constipation

In healthy individuals with functional constipation, probiotics supplementation does not appear to increase bowel movement frequency as compared with placebo, according to a study.

The study included 229 adults (median age 45 years, 84.7 percent female) with functional constipation according to Rome III criteria and a BMI of <30.0 kg/m² (mean 22.8 kg/m²). After 2 weeks of run-in, these participants were randomly assigned to consume probiotics (B lactis HN019, n=112) at 4.69 × 10⁹ colony forming units (CFU)/d (initial dose of 7.0 × 10⁹ colony forming units [CFU]/d) or placebo (n=117) once daily for 8 weeks.

Change in complete spontaneous bowel movements (CSBMs) was assessed as the primary outcome. Secondary outcomes were rescue medication use, stool consistency, degree of straining for each bowel movement, abdominal pain, and bloating. Dietary habits and physical activity were recorded. Additionally, faecal samples were collected and analysed for moisture content, short-chain fatty acids, branched-chain fatty acids, microbiota composition, and calprotectin.

At baseline, the mean CSBM was 0.77 per week. Mean CSBMs per week increased to 1.58 in the HN019 group and 1.50 in the placebo group, with the difference not reaching statistical significance (least square mean, 0.80 in the HN019 group vs 0.66 in the placebo group; p=0.37).

Likewise, no significant between-group difference was observed in the use of bisacodyl (4.5 percent vs 4.3 percent), stool consistency (mean Bristol Stool Scale score, 3.20 vs 3.10), degree of straining for each bowel movement, abdominal pain (difference in mean visual analogue scale [VAS] score for pain, −0.4 mm), and bloating (difference in mean VAS score for bloating, −0.8 mm).