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Probiotics Ameliorate Stool Consistency in Patients with Chronic Constipation: A Randomized, Double-Blind, Placebo-Controlled Study

Digestive Diseases and Sciences volume 63, pages 2754–2764 (2018)Cite this article

Abstract

Background/Aims

The efficacy of probiotics for improving clinical symptoms, altering the fecal microbiota, and regulating serum immune cytokine levels was investigated in patients with irritable bowel syndrome-constipation (IBS-C) or functional constipation (FC).

Methods

A randomized, double-blind, placebo-controlled trial was conducted at Kyung Hee University Hospital between October 2016 and February 2017. Consecutive 18–75-year-old patients with diagnosis of IBS-C or FC (based on Rome IV criteria) consumed probiotics (3.0 × 108 CFU/g Streptococcus thermophilus MG510 and 1.0 × 108 CFU/g Lactobacillus plantarum LRCC5193) or a placebo daily for 4 weeks (weeks 1–4) and were followed up for a 4-week washout period without intervention (weeks 5–8). The primary outcomes of the study were Bristol Stool Form Scale and Complete Spontaneous Bowel Movements (CSBM). Efficacy was assessed by per protocol.

Results

Stool consistency measured by the Bristol Stool Form Scale was significantly better in the probiotic group (n = 88) than in the placebo group (n = 83) at 4 and 8 weeks (3.7 ± 1.1 vs. 3.1 ± 1.1 at 8 weeks, P = 0.002). No significant difference was found in CSBM. The quality of life was significantly better in the probiotic group than in the placebo group at 4 weeks (P = 0.044) and 8 weeks (P = 0.049). The relative abundance of L. plantarum among the fecal microbiomes was significantly greater in the probiotic group than in the placebo group at 4 weeks (P = 0.029). However, the levels of other microbiomes and of serum cytokines (IL-10/IL-12 ratio and TNF-α) did not differ significantly between the two groups.

Conclusions

Probiotics significantly ameliorated stool consistency in patients with chronic constipation. In addition, the beneficial effect of L. plantarum on stool consistency remained after the probiotic supplementation was discontinued. The mechanism whereby probiotics benefit patients with chronic constipation should be clarified in further studies.

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Acknowledgments

This study was financially supported by Lotte Confectionery Co., Ltd, Korea.

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Author notes

  1. Jae Myung Cha and Sae Hun Kim contributed equally to this study as corresponding authors.

Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea

    Jin Young Yoon, Jae Myung Cha, Min Seob Kwak, Jung Won Jeon & Hyun Phil Shin

  2. Department of Food Bioscience and Technology, College of Life Science and Biotechnology, Korea University, Seoul, 02841, Republic of Korea

    Ju Kyoung Oh, Pei Lei Tan & Sae Hun Kim

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  1. Jin Young Yoon
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Yoon, J.Y., Cha, J.M., Oh, J.K. et al. Probiotics Ameliorate Stool Consistency in Patients with Chronic Constipation: A Randomized, Double-Blind, Placebo-Controlled Study. Dig Dis Sci 63, 2754–2764 (2018). https://doi.org/10.1007/s10620-018-5139-8

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  • DOI: https://doi.org/10.1007/s10620-018-5139-8

Keywords

  • Probiotics
  • Irritable bowel syndrome
  • Constipation
  • Lactobacillus plantarum