Mechanisms of Action of Probiotics and the Gastrointestinal Microbiota on Gut Motility and Constipation
Open accessAbstract
Constipation is a common and burdensome gastrointestinal disorder that may result from altered gastrointestinal motility. The effect of probiotics on constipation has been increasingly investigated in both animal and human studies, showing promising results. However, there is still uncertainty regarding the mechanisms of action of probiotics on gut motility and constipation. Several factors are vital to normal gut motility, including immune and nervous system function, bile acid metabolism and mucus secretion, and the gastrointestinal microbiota and fermentation; an imbalance or dysfunction in any of these components may contribute to aberrant gut motility and, consequently, symptoms of constipation. For example, adults with functional constipation have significantly decreased numbers of bifidobacteria (with one study showing a mean difference of 1 log 10/g) and lactobacilli (mean difference, 1.4 log 10/g) in stool samples, as well as higher breath methane, compared with control subjects. Modifying the gut luminal environment with certain probiotic strains may affect motility and secretion in the gut and, hence, provide a benefit for patients with constipation. Therefore, this review explores the mechanisms through which probiotics may exert an effect on gut motility and constipation. Nevertheless, the majority of current evidence is derived from animal studies, and therefore, further human studies are needed to determine the mechanisms through specific probiotic strains that might be effective in constipation.
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Gut microbiota plays a crucial role in gut motility.
“Gut microbiota, which comprises a complex community of micro-organisms inhabiting the gastrointestinal tract, including bacteria, viruses, fungi and other micro-organisms, plays a crucial role in gut motility.6”
Patients with chronic constipation often exhibit increased proliferation of T cells and lymphocytes such as CD4+ T cells and CD8+ T cells, indicating activation of T cell-mediated cellular immunity.
“Patients with chronic constipation often exhibit increased proliferation of T cells and lymphocytes such as CD4 + T cells and CD8 + T cells, indicating the activation of T cellmediated cellular immunity.”
From Chronic constipation and gut microbiota: current research insights and therapeutic implications (2024) · cites this paper as [27]
Inflammation-induced adherence and immune responses by CD8+ T cells on intestinal neurons can lead to acute neuronal injury, colorectal dilation, and slowed colonic water transport, resulting in development or worsening of constipation symptoms.
“Inf lammation-induced adherence and immune responses by CD8 + T cells on intestinal neurons can lead to acute neuronal injury, colorectal dilation, and slowed colonic water transport, which can result in the development or worsening of constipation symptoms [27].”
From Chronic constipation and gut microbiota: current research insights and therapeutic implications (2024) · cites this paper as [27]
Substance P stored in visceral neurons stimulates smooth muscle contraction and amplifies visceral pain; when constipation occurs in central nervous system disorders, nerves containing SP are stimulated, leading to release of stored SP and resulting in abdominal pain.
“In addition, substance P (SP) stored in visceral neurons stimulates smooth muscle contraction and amplifies visceral pain; when constipation occurs in central nervous system disorders, nerves containing SP are stimulated, leading to the release of stored SP and resulting in abdominal pain [8,22,27].”
From Chronic constipation and gut microbiota: current research insights and therapeutic implications (2024) · cites this paper as [27]
The production of endogenous substances by the intestinal microbiota can affect intestinal motility.
“The production of endogenous substances by the intestinal microbiota can also affect intestinal motility [27,31,38].”
From Chronic constipation and gut microbiota: current research insights and therapeutic implications (2024) · cites this paper as [27]
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- Authors
- Dimidi, E., Christodoulides, S., Scott, S. M., & Whelan, K.
- Affiliations
- Queen Mary University of London (GB)
- King's College London (GB)
- Corresponding author
- Whelan, Kevin
- Venue
- Advances in Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-05
- Volume
- 8
- Issue
- 3
- Pages
- 484-494
- ISSN
- 2156-5376 (ISSN-L)
- 2161-8313
- PMC
- PMC5421123
- OpenAlex
- W2615801135
- Cited by
- 468
- References
- 108
- Citations by year
- 2026: 36 · 2025: 68 · 2024: 90 · 2023: 70 · 2022: 73 · 2021: 52 · 2020: 39 · 2019: 23 · 2018: 14 · 2017: 3
- FWCI
- 3.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Advances in Nutrition (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- 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, constipation, intestinal motility, gut microbiota, Bifidobacterium, lactobacilli, bile acid metabolism, mucus secretion, gut fermentation, breath methane, functional constipation, immune function, nervous system function
- MeSH terms
- Gastrointestinal Microbiome, Animals, Constipation, Gastrointestinal Diseases, Gastrointestinal Motility, Humans, Probiotics, Gastrointestinal Tract
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