Probiotics, prebiotics, and synbiotics in chronic constipation: Outstanding aspects to be considered for the current evidence
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This integrative aimed to evaluate the effects and the potential mechanism of action of prebiotics, probiotics, and synbiotics on constipation-associated gastrointestinal symptoms and to identify issues that still need to be answered. A literature search was performed in the PubMed database. Animal models (n = 23) and clinical trials (n = 39) were included. In animal studies, prebiotic, probiotic, and synbiotic supplementation showed a decreased colonic transit time (CTT) and an increase in the number and water content of feces. In humans, inulin is shown to be the most promising prebiotic, while B. lactis and L. casei Shirota probiotics were shown to increase defecation frequency, the latter strain being more effective in improving stool consistency and constipation symptoms. Overall, synbiotics seem to reduce CTT, increase defecation frequency, and improve stool consistency with a controversial effect on the improvement of constipation symptoms. Moreover, some aspects of probiotic use in constipation-related outcomes remain unanswered, such as the best dose, duration, time of consumption (before, during, or after meals), and matrices, as well as their effect and mechanisms on the regulation of inflammation in patients with constipation, on polymorphisms associated with constipation, and on the management of constipation via 5-HT. Thus, more high-quality randomized control trials (RCTs) evaluating these lacking aspects are necessary to provide safe conclusions about their effectiveness in managing intestinal constipation.
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In the included studies, the most common probiotics ingredients were Bifidobacterium and Lactobacillus, and the most common prebiotics ingredients were inulin, fructooligosaccharide and psyllium.
“In our included studies, the most popular probiotics ingredients were Bifidobacterium and Lactobacillus, while the most popular prebiotics ingredients were inulin, fructooligosaccharide and psyllium.51”
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 [51]
The Results sections (page unavailable) identify Bifidobacterium and Lactobacillus strains as the most frequently assessed probiotics and inulin as the most evaluated prebiotic in the review’s human studies. They mention fructooligosaccharides and psyllium, but do not identify either as among the most common prebiotic ingredients. The source also cannot establish which ingredients were most common in the citing authors’ own included studies. (LLM, conf=0.88)
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- Authors
- Araújo, M. M., & Botelho, P. B.
- Affiliations
- Universidade de Brasília (BR)
- Corresponding author
- Botelho, Patrícia Borges
- Venue
- Frontiers in Nutrition
- Publisher
- Frontiers Media SA
- Published
- 2022-12-08
- Volume
- 9
- Pages
- 935830-935830
- ISSN
- 2296-861X (ISSN-L)
- PMC
- PMC9773270
- OpenAlex
- W4311865063
- Cited by
- 58
- References
- 124
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 13 · 2023: 14
- FWCI
- 2.42
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Nutrition (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- 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
- probiotics, prebiotics, synbiotics, chronic constipation, colonic transit time, inulin, Bifidobacterium animalis subsp. lactis, Lactobacillus casei Shirota, stool frequency, stool consistency, serotonin, inflammation, genetic polymorphism
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