Systematic review of randomised controlled trials: Probiotics for functional constipation

Table 2 The summary of study outcomes

Study ID	Probiotic	Outcomes
Studies in adults
Mollenbrink et al[13] 1994 (Germany)	E. coli Nissle 19171	Number of stools per week [week 4: 4.9 ± 1.5 vs 2.6 ± 1.0, MD 2.3 (95% CI 1.7 to 2.9); week 8: MD 4.1 (95% CI 3.2 to 5)]
		Hard stools [2/34 vs 16/30, RR 0.1 (95% CI 0.03 to 0.4) (P < 0.001)]
		Effectiveness of a probiotic compared to placebo assessed by physicians: 55.9% vs 6.7%
		Effectiveness of a probiotic compared to placebo assessed by patients: 52.9% vs 6.7% (P < 0.001)
		Tolerance of a probiotic compared to placebo assessed by physicians: 58.85% vs 26.7% (P = 0.01)
		Tolerance of a probiotic compared to placebo assessed by patients: 50% vs 26.7% (P = 0.03)
Koebnick et al[12] 2003 (Germany)	L. casei Shirota2	Occurrence of moderate and severe constipation (P < 0.001)
		Degree of constipation (P = 0.003)
		Defecation frequency (P = 0.004)
		Occurrence of hard stools (P < 0.001)
		Degree of stool consistency (P < 0.001)
		Occurrence of flatulence (NS)
		Degree of flatulence (NS)
		Occurrence of bloating (NS)
		Degree of bloating (NS)
Yang et al[14] 2008 (China)	B. lactis DN-173 0101	Stool frequency (n/wk) [week 1: 3.5 ± 1.5 vs 2.5 ± 0.9, MD 1 (95% CI 0.6 to 1.4); week 2: 4.1 ± 1.7 vs 2.6 ± 1.0; MD 1.5 (95% CI 0.7 to 1.6)]
		Defection condition scores [week 1: 1.1 ± 0.9 vs 1.6 ± 1.1, MD -0.5 (95% CI -0.85 to -0.18); week 2: 0.8 ± 1.0 vs 1.6 ± 1.1; MD -0.8 (95% CI -1.14 to -0.44)]
		Grade I (0 points)-normal defecation
		Grade II (1 point)-only bearing down and uncomfortable sensation
		Grade III (2 points)-obvious bearing down and uncomfortable sensation, or frequent defecation with difficult and little defecation, seldom abdominal pain or anal burning sensation
		Grade IV (3 points)-often abdominal pain or anal burning sensation to influence defecation
		Stool consistency scores (according to classification method of Bristol) [week 1: 1.0 ± 0.8 vs 1.4 ± 1.0, MD -0.4 (95% CI -0.73 to -0.12); week 2: 0.6 ± 0.8 vs 1.3 ± 1.0, MD -0.7 (95% CI -1 to -0.4)]
		Grade I (0 points)-like sausage or snake, smooth and soft; like sausage, with fissure on the surface
		Grade II (1 point)-sausage-shaped, with lumps; noncohesive lumps, with coarse edges
		Grade III (2 points)-separating hard lumps, like fruit kernel (difficult discharge)
Studies in children
Banaszkiewicz et al[17] 2005 (Poland)	L. rhamnosus GG2	Treatment success (≥ 3 spontaneous BMs per week with no episodes of faecal soiling) (NS)
		Number of BMs per week (NS)
		Number of episodes of faecal soling per week (NS)
		Straining at defecation frequency per week (NS)
Bu et al[16] 2007 (Taiwan)	L. casei rhamnosus Lcr351	Treatment success (≥ 3 spontaneous BMs per week with no episodes of faecal soiling in the fourth week) (14/18 vs 1/9, RR 7, 95% CI 1.1 to 45; P = 0.01)
		Defecation frequency (times/d) (0.57 ± 0.17 vs 0.37 ± 0.1; MD 0.2, 95% CI 0.1 to 0.3)(P = 0.03)
		Hard stool (%) (22.4 ± 14.7 vs 75.5 ± 6.1; MD -53% (95% CI -63 to -43) ((P = 0.01)
		Abdominal pain (times) (1.9 ± 1.6 vs 6.7 ± 3.3; MD -4.8, 95% CI -6.6 to -3) (P = 0.03)
		Use of glycerin enema (times) (1.6 ± 1.9 vs 4.0 ± 2.1; MD -2.4, 95% CI -4 to -0.8) (P = 0.04)
		Use of lactulose (times) (4.4 ± 3.6 vs 6.2 ± 3.8; MD -1.8, 95% CI -4.7 to 1.1) (P = 0.66)
		Faecal soiling (times) (2.1 ± 3.8 vs 2.7 ± 1.4, MD -0.6 (95% CI -3.2 to 2) (P = 0.95)
		Change of appetite (0.7 ± 0.8 vs 0.7 ± 0.6; MD 0, 95% CI -0.6 to 0.6) (P = 0.81)

¹Mean values are presented for the experimental group and control group, respectively;

²Comparisons of experimental and control group. NS: Not significant.