Cited by 316Gastrointestinal motility and disordersProbiotics and Fermented FoodsGut microbiota and health

The DOI matches its Crossref record; 62 of the 63 references it cites were found in a registry or an index.

The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials

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Abstract

Background Functional constipation is a prevalent, burdensome gastrointestinal disorder whose treatment remains challenging. Probiotics have been increasingly investigated in its management.Objective The aim was to investigate the effect of probiotics on gut transit time, stool output, and constipation symptoms in adults with functional constipation via a systematic review and meta-analysis of randomized controlled trials (RCTs).Design Studies were identified by searching 4 electronic databases, back-searching reference lists, contacting authors, and hand-searching abstracts. RCTs that reported administration of probiotics in adults with functional constipation were included. Two reviewers independently performed the screening, data extraction, and bias assessment. Outcome data were synthesized by using weighted mean differences (WMDs) or standardized mean differences (SMDs) with the use of a random-effects model.Results A total of 660 records were identified of which 14 were eligible (1182 patients). Overall, probiotics significantly reduced whole gut transit time by 12.4 h (95% CI: -22.3, -2.5 h) and increased stool frequency by 1.3 bowel movements/wk (95% CI: 0.7, 1.9 bowel movements/wk), and this was significant for Bifidobacterium lactis (WMD: 1.5 bowel movements/wk; 95% CI: 0.7, 2.3 bowel movements/wk) but not for Lactobacillus casei Shirota (WMD: -0.2 bowel movements/wk; 95% CI: -0.8, 0.9 bowel movements/wk). Probiotics improved stool consistency (SMD: +0.55; 95% CI: 0.27, 0.82), and this was significant for B. lactis (SMD: +0.46; 95% CI: 0.08, 0.85) but not for L. casei Shirota (SMD: +0.26; 95% CI: -0.30, 0.82). No serious adverse events were reported. Attrition and reporting bias were high, whereas selection bias was unclear due to inadequate reporting.Conclusions Probiotics may improve whole gut transit time, stool frequency, and stool consistency, with subgroup analysis indicating beneficial effects of B. lactis in particular. However, caution is needed with the interpretation of these data due to their high heterogeneity and risk of bias. Adequately powered RCTs are required to better determine the species or strains, doses, and duration of use of probiotics that are most efficacious.

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  1. He, 2009, Effect of probiotic yogurt containing Bifidobacterium animalis strain DN-173 010 on symptoms of constipation, Chin J Gastroenterol, 14, 287
  2. Takii, 2012, Effects of fermented milk containing Bifidobacterium animalis subsp. lactis GCL2505 on improvement of defecation, fecal properties, and intestinal microflora, Jpn Pharmacol Ther, 40, 657

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Metadata

Authors
Dimidi, E., Christodoulides, S., Fragkos, K. C., Scott, S. M., & Whelan, K.
Affiliations
Queen Mary University of London (GB)
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
2014-10
Volume
100
Issue
4
Pages
1075-1084
ISSN
0002-9165 (ISSN-L)
OpenAlex
W2012951812
Cited by
316
References
63
Citations by year
2026: 21 · 2025: 26 · 2024: 21 · 2023: 34 · 2022: 29 · 2021: 28 · 2020: 32 · 2019: 28 · 2018: 32 · 2017: 33 · 2016: 13 · 2015: 18 · 2014: 1
FWCI
3.55
Type
journal article
Language
en
Open access
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
Nestec
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
probiotics, functional constipation, gut transit time, stool frequency, stool consistency, Bifidobacterium animalis subsp. lactis, Lactobacillus casei Shirota, adults, constipation treatment, adverse events, reporting bias, attrition bias, selection bias, subgroup analysis, quality of evidence, gut microbiota, dietary fat, dietary fiber intake
MeSH terms
Constipation, Defecation, Humans, Randomized Controlled Trials as Topic, Probiotics

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