Microbiota treatment of functional constipation: Current status and future prospects

Table 1 Summary of important studies on microecological regulators in the treatment of functional constipation from 2018 to 2024

Ref.	Study type	Agent in the treatment group	Study population	Daily dosage and duration	Conclusion
Yoon et al[16], 2018	RCT	S. thermophilus MG510 and L. plantarum LRCC5193	171 patients (88 probiotics, 83 placebo)	MG510 7.8 × 109 CFU and LRCC5193 2.6 × 109 CFU; 4 wk	Probiotics ameliorated stool consistency
Ibarra et al[17], 2018	RCT	B. animalis subsp. lactis HN019	228 patients (76 high dose HN019, 76 low dose HN019, 76 placebo)	1 × 109 CFU or 1 × 1010 CFU; 4 wk	HN019 improved bowel movement frequency in adults with fewer than 3 stools per week
Lim et al[18], 2018	RCT	L.plantarum LP01, B. lactis BB12, and inulin-oligofructose	85 patients (43 synbiotics, 42 placebo)	1 × 1010 CFU, 2.5 g; 12 wk	Synbiotics improved constipation symptoms but failed to demonstrate benefits over the controls
Dimidi et al[19], 2019	RCT	B.lactis NCC2818	75 patients (37 NCC2818, 38 placebo)	1.5 × 1010 CFU; 4 wk	NCC2818 was not effective in the management of mild chronic constipation
Riezzo et al[20], 2019	RCT	L. reuteri DSM17938	56 patients (28 DSM17938, 28 placebo)	4 × 108 CFU for 15 d and then 2 × 108 CFU for 90 d	DSM17938 improved functional constipation by affecting 5-HT and brain-derived neurotrophic factor serum concentrations
Ou et al[21], 2019	Before–after study	L. casei strain Shirota	16 patients with constipation and 22 patients without constipation	1 × 1010 CFU; 4 wk	Shirota improved defecation frequency, stool consistency, and constipation-related symptoms
Kasugai et al[22], 2019	RCT	A crystalline lactulose preparation (SK-1202)	250 patients (63 SK-1202 at 13 g, 63 SK-1202 at 26 g, 62 SK-1202 at 39 g, 62 placebo)	13, 26, or 39 g; 2 wk	SK-1202 increased SBMs, and the optimal dose was 26 g/d
Chu et al[23], 2019	RCT	Prebiotic UG1601 (inulin, lactitol, and aloe vera gel)	40 patients (20 UG1601, 20 placebo)	13 g; 4 wk	Prebiotic failed to demonstrate benefits over the controls in symptom improvement but helped alleviate endotoxemia
Wang et al[24], 2022	RCT	B.bifidum CCFM16	103 patients (53 CCFM16, 50 placebo)	2 × 109 CFU; 4 wk	CCFM16 improved stool consistency and SBMs by regulating the gut microbiota and SCFA metabolism
Schoemaker et al[25], 2022	RCT	GOS	132 patients (45 GOS at 5.5 g, 44 GOS at 11 g, 43 placebo)	5.5 or 11 g; 3 wk	GOS at 11 g increased stool frequency in subjects with low stool frequency at baseline and in adults with self-reported constipation
Takeda et al[26], 2023	RCT	B. longum BB536	79 patients (38 BB536, 41 placebo)	5 × 1010 CFU; 4 wk	BB536 improved the bowel movements and upper abdominal symptoms of elderly patients
Patch et al[27], 2023	RCT	B. subtilis BG01-4TM	67 participants (34 BG01-4™, 33 placebo)	5 × 109 CFU; 4 wk	BG01-4™ improved specific symptoms of constipation and related gastrointestinal dysfunction
Ma et al[28], 2023	RCT	L. plantarum P9	163 patients (78 P9, 85 placebo)	1 ×1011 CFU; 6 wk	P9 improved the frequency of bowel movements and enriched potentially beneficial bacteria
Venkataraman et al[29], 2023	RCT	B. coagulans Unique IS2 and lactulose	150 patients (50 Unique IS2 with lactulose, 50 lactulose, 50 placebo)	Unique IS2 2 × 109 spores, lactulose at 10 g; 4 wk	Unique IS2 with lactulose was more effective than lactulose alone in relieving symptoms of constipation in a short period
Erhardt et al[30], 2024	RCT	A prebiotic formulation with PHGG and acacia gum as main ingredients	61 participants (31 prebiotics, 30 placebo)	PHGG at 6000 mg, acacia gum at 2000 mg, and other formulations; 3 wk	Prebiotics significantly increased CSBMs and were associated with a decrease in species richness and Shannon diversity

SBMs: Spontaneous bowel movements; GOS: Galactooligosaccharides; PHGG: Partially hydrolyzed guar gum; CSBMs: Complete spontaneous bowel movements.