Systematic review of randomised controlled trials: Probiotics for functional constipation

doi:10.3748/wjg.v16.i1.69

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jan 7, 2010; 16(1): 69-75
Published online Jan 7, 2010. doi: 10.3748/wjg.v16.i1.69

Systematic review of randomised controlled trials: Probiotics for functional constipation

Anna Chmielewska, Hania Szajewska

Anna Chmielewska, Hania Szajewska, Department of Paediatrics, The Medical University of Warsaw, 01-184 Warsaw, Dzialdowska 1, Poland

Author contributions: Szajewska H wrote the initial protocol of the review; Chmielewska A and Szajewska H were responsible for the literature search, study selection, methodological quality assessment, and data extraction; Szajewska H and Chmielewska A conducted the analyses and wrote the manuscript; Both authors contributed to the data interpretation; Szajewska H and Chmielewska A wrote the final report, which was approved by both authors; Szajewska H is the guarantor.

Supported by The Medical University of Warsaw, Poland

Correspondence to: Hania Szajewska, MD, Department of Paediatrics, The Medical University of Warsaw, 01-184 Warsaw, Dzialdowska 1, Poland. hania@ipgate.pl

Telephone: +48-22-4523309 Fax: +48-22-4523309

Received: September 23, 2009
Revised: October 26, 2009
Accepted: November 2, 2009
Published online: January 7, 2010

Abstract

AIM: To systematically evaluate and update evidence on the efficacy and safety of probiotic supplementation for the treatment of constipation.

METHODS: The MEDLINE, EMBASE, CINAHL, and Cochrane Library databases were searched in May 2009 for randomised controlled trials (RCTs) performed in paediatric or adult populations related to the study aim.

RESULTS: We included five RCTs with a total of 377 subjects (194 in the experimental group and 183 in the control group). The participants were adults (three RCTs, n = 266) and children (two RCTs, n = 111) with constipation. In adults, data suggests a favourable effect of treatment with Bifidobacterium lactis DN-173 010, Lactobacillus casei Shirota, and Escherichia coli Nissle 1917 on defecation frequency and stool consistency. In children, L. casei rhamnosus Lcr35, but not L. rhamnosus GG, showed a beneficial effect.

CONCLUSION: Until more data are available, we believe the use of probiotics for the treatment of constipation condition should be considered investigational.

Keywords: Randomised controlled trials; Constipation; Probiotics; Adults; Children