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Cited by 12Gastrointestinal motility and disordersProbiotics and Fermented FoodsMicrobial Metabolites in Food Biotechnology

Do synbiotics really enhance beneficial synbiotics effect on defecation symptoms in healthy adults?: Randomized, double-blind, placebo-controlled trial

Open access
Ito, Daisaku, Yamamoto, Yuta, Maekita, Takao, Yamagishi, Naoko, Kawashima, Shuji, Yoshikawa, Takanori, Tanioka, Kensuke, Yoshida, Takeichi +5 more·2022·Medicine
DOI 10.1097/md.0000000000028858PMC PMC8878738
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Abstract

GOALS: We examined whether synbiotics enhance improvement by probiotics. BACKGROUND: Probiotics, which are beneficial microbacteria, are a nutritional intervention for treatment of functional constipation or its tendency. Prebiotics, meanwhile, can promote the proliferation of probiotics in the gastrointestinal tract and enhance their beneficial effects. Synbiotics, a combination of probiotics and prebiotics, may be superior to probiotics in the treatment of defecation-related symptoms, but this requires elucidation. STUDY: This randomized, double-blind, placebo-controlled study enrolled 69 healthy adults with constipation tendency. Participants were allocated to either control, probiotics, or synbiotics groups and they recorded details of their defecations and their condition. The first 2 weeks were the observation period and the latter 2 weeks were the intervention period, in which participants took test foods. Probiotic foods included Bifidobacterium longum NT strain (1010 CFU/day), synbiotic foods included the NT strain (1010 CFU/day) and galactooligosaccharide (1 g/day). Placebo foods contained the vehicle only. Participants answered questionnaires (Patient Assessment on Constipation Symptoms [PAC-SYM], and one on dietary history) on the last day of each period. RESULTS: Nine participants withdrew consent, and 2 of the remaining 60 had missing data. Age, body mass index, and sex were not significantly different between the 3 groups. Frequency of bowel movements in the fourth week, the primary endpoint, was not increased in the probiotics or synbiotics groups compared with the control group, and the frequency of bowel movements and days with defecation were not changed by probiotics or synbiotics during the intervention period. Probiotics and synbiotics did not improve stool conditions, although incomplete defecation was improved by probiotics but not by synbiotics compared with placebo. PAC-SYM indicated that stool condition and total scores were improved by probiotics but not by synbiotics during the intervention compared with placebo. CONCLUSION: The probiotic strain Bifidobacterium longum NT can improve constipation symptoms, especially stool condition, but it does not increase bowel movement frequency in healthy adults with constipation tendency. Synbiotics treatment seemed to diminish this improvement of constipation induced by probiotics. This study indicates the possibility of attenuation of beneficial effects from probiotics by the use of synbiotics, contrary to synbiotics theory.

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  • The systematic review included 17 randomised controlled trials comprising 1256 adult patients with functional constipation.

    “17 studies, comprising 1256 participants, were included with perfect agreements between two researchers (kappa statistic=0.797).”

    From Efficacy in bowel movement and change of gut microbiota on adult functional constipation patients treated with probiotics-containing products: a systematic review and meta-analysis (2024) · cites this paper as [20]

    The Abstract (Study) describes a single randomized trial enrolling 69 healthy adults with a tendency toward constipation, not a systematic review of 17 trials and 1,256 patients. The Materials and methods (Participants) also state that people diagnosed with constipation or meeting Rome IV criteria were excluded. (LLM, conf=0.94)

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Authors
Ito, D., Yamamoto, Y., Maekita, T., Yamagishi, N., Kawashima, S., Yoshikawa, T., Tanioka, K., Yoshida, T., Iguchi, M., Kunitatsu, K., Kanai, Y., Kato, S., & Kitano, M.
Affiliations
Wakayama Medical University (JP)
Corresponding author
Yamamoto, Yuta
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-02-25
Volume
101
Issue
8
Pages
e28858
ISSN
  • 0025-7974 (ISSN-L)
  • 1536-5964
DOI
10.1097/md.0000000000028858
PMC
PMC8878738
OpenAlex
W4214628470
Cited by
12
References
34
Citations by year
2026: 2 · 2025: 3 · 2024: 4 · 2022: 3
FWCI
2.19
Type
journal article
Language
en
Open access
Licence
Locations
  • Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Noster Inc. (no)
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
Keywords
synbiotics, probiotics, prebiotics, galactooligosaccharides, defecation symptoms, stool frequency
MeSH terms
Bifidobacterium longum, Adult, Constipation, Defecation, Double-Blind Method, Female, Humans, Male, Treatment Outcome, Probiotics, Prebiotics, Synbiotics, Healthy Volunteers

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