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Probiotics Aid in Relieving Constipation

Constipation in the elderly

 

Constipation among older people is a very prominent and prevalent health problem, particularly in the institutionalised elderly. Several  studies report that about half of all nursing home residents suffer from chronic constipation. Studies have shown that administering probiotics can improve constipation by increasing colonic transit, defecation frequency, and faeces stiffening. However, research is scarce on the effect of probiotic administration specifically addressing the elderly. Therefore, in order to recommend interventions in the treatment of constipation, Spanish researchers reviewed the current scientific evidence on probiotics and constipation and evaluated the efficiency of probiotics in treating constipation in elderly people

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Probiotics can be used as a therapeutic tool to treat constipation in elderly

 

 

Chronic constipation is a common problem among the elderly. About half of all nursing home residents suffer from chronic constipation and more than 70% of them use laxatives on a daily basis (1).  Although laxatives are effective, they can have several side effects. An alternative to improve constipation may be the administration of probiotics. Indeed, studies have reported that the administration of probiotics can improve constipation in the general population by increasing colonic transit, defecation frequency, and changing the consistency of the faeces (2). However, the effect of probiotic administration in the elderly has not been specifically addressed. A recent study therefore determined the effect of probiotic administration in elderly (3). Here, a systematic review of the current scientific evidence was conducted, by analysing only the data from a cohort of individuals aged 60 years or more. Of the 475 identified studies, 9 were included (5 randomized and placebo-controlled clinical trials (RCT) and 4 observational studies). 

Results

 

The administration of probiotics produced a significant positive effect on constipation in all RCT’s analysed.  Three studies determined the effect of probiotics on frequency defecation and showed that the administration of probiotics significantly increased the frequency defecation compared tot the control group (p=0.0021, p=0.038 and p=0.001). Two studies determined the effect of probiotics on the intestinal transit and both studies showed that the intestinal transit was significantly increased in the probiotics group compared to the control group (p = 0.004 and p = 0.002). Another study showed that the use of laxatives was significantly decreased in the probiotic group compared to the control group  (p = 0.0439). The observational studies showed that the administration of a multispecies probiotic resulted in 24% increase in defecation frequency compared to baseline value. This outcome was significant (p = 0.0431). Observational studies using a monospecies probiotic found no significant effect. 

The findings of this systematic review suggest that multispecies probiotics can be used as an additional therapeutic tool to treat constipation in elderly.  Although more research is needed on the specific strain(s) of probiotics that should be used, it is  noteworthy that according to this systematic review the Bifidobacterium longum seems to be the most commonly used probiotic that had beneficial effects on constipation severity in elderly populations. From a meta-analysis that assessed the effect of probiotic administration in adults with constipation (4), it appeared that this probiotic bacterium is most effective against constipation.

 

 

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B. longum seemed to be the most commonly used probiotic that had beneficial effects on constipation severity in elderly populations 

 

 

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References

 

(1) Gallegos-Orozco, J. F., Foxx-Orenstein, A. E., Sterler, S. M., & Stoa, J. M. (2012). Chronic constipation in the elderly. The American journal of gastroenterology107(1), 18-25.

(2) Koebnick, C., Wagner, I., Leitzmann, P., Stern, U., & Zunft, H. J. (2003). Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Canadian Journal of Gastroenterology and Hepatology, 17(11), 655-659.

(3) Martínez-Martínez, M. I., Calabuig-Tolsá, R., & Cauli, O. (2017). The effect of probiotics as a treatment for constipation in elderly people: A systematic review. Archives of Gerontology and Geriatrics. (

4) Dimidi, E., Christodoulides, S., Fragkos, K. C., Scott, S. M., & Whelan, K. (2014). The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. The American journal of clinical nutrition100(4), 1075-1084. 

 

 

 

Probiotics aid in relieving constipation

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