Probiotics cause constipation
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The Impact of Probiotics on Constipation: A Comprehensive Review
Introduction to Probiotics and Constipation
Constipation is a common gastrointestinal disorder characterized by infrequent bowel movements, hard stools, and difficulty in passing stools. Probiotics, which are live microorganisms that confer health benefits to the host, have been increasingly studied for their potential to alleviate constipation symptoms. This article synthesizes findings from multiple research studies to evaluate whether probiotics cause constipation or, conversely, help in its management.
Probiotics and Gut Transit Time
Reduction in Gut Transit Time
Several studies have demonstrated that probiotics can significantly reduce whole gut transit time (GTT). A meta-analysis of randomized controlled trials (RCTs) found that probiotics reduced GTT by approximately 12.4 hours1. Another study corroborated these findings, showing a reduction of 13.75 hours in GTT with probiotic consumption2. These reductions suggest that probiotics can enhance gut motility, thereby alleviating constipation symptoms.
Probiotics and Stool Frequency
Increase in Stool Frequency
Probiotics have been shown to increase stool frequency in individuals with constipation. One systematic review and meta-analysis reported an increase of 1.3 bowel movements per week with probiotic use, particularly with Bifidobacterium lactis1. Another meta-analysis found a similar increase of 0.98 bowel movements per week, with multispecies probiotics showing the most significant effect2. These findings indicate that probiotics can help normalize bowel movement frequency in constipated individuals.
Probiotics and Stool Consistency
Improvement in Stool Consistency
Probiotics also appear to improve stool consistency. Studies have shown that probiotics, especially multispecies formulations, significantly enhance stool consistency2 5. For instance, Bifidobacterium lactis was found to improve stool consistency in several trials1 3. This improvement can make bowel movements easier and less painful for individuals suffering from constipation.
Probiotics in Special Populations
Elderly and Parkinson’s Disease Patients
Probiotics have been studied in specific populations, such as the elderly and patients with Parkinson’s disease (PD). In elderly individuals, probiotics were found to improve constipation by 10-40% compared to placebo9. In PD patients, multi-strain probiotics significantly increased spontaneous bowel movements and improved stool consistency6 7. These findings suggest that probiotics can be particularly beneficial in populations with higher constipation prevalence.
Safety and Adverse Effects
Lack of Serious Adverse Events
The reviewed studies consistently reported that probiotics are generally safe and well-tolerated. No serious adverse events were associated with probiotic use in the trials1 2 5. This safety profile makes probiotics a viable option for managing constipation without significant risk of adverse effects.
Conclusion
In summary, the current body of research suggests that probiotics do not cause constipation; rather, they can be effective in reducing gut transit time, increasing stool frequency, and improving stool consistency. These benefits are observed across various populations, including the elderly and individuals with Parkinson’s disease. While probiotics are generally safe, further high-quality RCTs are needed to determine the most effective strains, doses, and treatment durations for managing constipation.
Sources and full results
Most relevant research papers on this topic
The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials.
Probiotics may improve gut transit time, stool frequency, and stool consistency in adults with functional constipation, but more rigorous research is needed to determine the most effective strains, doses, and duration of use.
Meta-Analysis
Very Rigorous Journal
Highly CitedMeta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults.
Probiotics, particularly multispecies probiotics, can significantly reduce gut transit time, increase stool frequency, and improve stool consistency in adults with functional constipation.
Meta-AnalysisVery Rigorous JournalHighly CitedProbiotics, prebiotics, and synbiotics in chronic constipation: Outstanding aspects to be considered for the current evidence
Prebiotics and probiotics can improve stool consistency and reduce colonic transit time, but more high-quality randomized control trials are needed to confirm their effectiveness in managing intestinal constipation.
Systematic ReviewMechanisms of Action of Probiotics and the Gastrointestinal Microbiota on Gut Motility and Constipation.
Probiotics may improve gut motility and constipation by affecting gut secretion and function, but further human studies are needed to determine specific strains' effectiveness.
Literature ReviewVery Rigorous JournalHighly CitedThe efficacy and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: a systematic review and meta-analysis based on seventeen randomized controlled trials.
Probiotics may be safe and may improve gut transit time, stool frequency, and consistency in patients with constipation-predominant irritable bowel syndrome.
Meta-AnalysisProbiotics for constipation in Parkinson's disease: A randomized placebo-controlled study.
Multi-strain probiotics effectively increased the average number of spontaneous bowel movements per week in Parkinson's disease patients, improving stool consistency and quality of life.
RCT
Rigorous JournalHighly CitedMulti-strain probiotics (Hexbio) containing MCP BCMC strains improved constipation and gut motility in Parkinson’s disease: A randomised controlled trial
A multi-strain probiotic (Hexbio) containing MCP BCMC strains significantly improved bowel opening frequency and gut transit time in Parkinson's disease patients with constipation over 8 weeks.
RCTRigorous JournalHighly CitedEffect of multispecies probiotic on gut microbiota composition in individuals with intestinal constipation: A double-blind, placebo-controlled randomized trial.
Multispecies probiotics in capsule form may modulate gut microbiota by reducing bacteria commonly increased in individuals with constipation, contributing to the balance and well-being of the individual.
RCTThe effect of probiotics as a treatment for constipation in elderly people: A systematic review.
Probiotics significantly improve constipation in elderly individuals by 10-40% compared to placebo controls, with Bifidobacterium longum being the most commonly tested strain.
Systematic ReviewPositive Effect of Probiotics on Constipation in Children: A Systematic Review and Meta-Analysis of Six Randomized Controlled Trials
Probiotics increase stool frequency in children with constipation, particularly in Asian children, but do not significantly affect stool consistency.
Meta-Analysis