GUT MICROBIOTA AND THE USE OF PROBIOTICS IN CONSTIPATION IN CHILDREN AND ADOLESCENTS: SYSTEMATIC REVIEW.

Daiane Oliveira Vale San Gomes,Mauro Batista De Morais

doi:10.1590/1984-0462/2020/38/2018123

Daiane Oliveira Vale San Gomes, Mauro Batista De Morais

Open Access

https://doi.org/10.1590/1984-0462/2020/38/2018123

Copy DOI

Abstract

ABSTRACTObjective: To perform a systematic review of literature data on gut microbiota and the efficacy of probiotics for the treatment of constipation in children and adolescents.Data source: The research was performed in the PubMed, the Scientific Electronic Library Online (SciELO) and the Latin American and Caribbean Health Sciences Literature (LILACS) databases in English, Portuguese and Spanish. All original articles that mentioned the evaluation of the gut microbiota or the use of probiotics in children with constipation in their title and abstract were selected.Data synthesis: 559 articles were found, 47 of which were selected for reading. From these, 12 articles were included; they studied children and adolescents divided into two categories: a gut microbiota evaluation (n=4) and an evaluation of the use of probiotics in constipation therapy (n=8). The four papers that analyzed fecal microbiota used different laboratory methodologies. No typical pattern of gut microbiota was found. Regarding treatment, eight clinical trials with heterogeneous methodologies were found. Fifteen strains of probiotics were evaluated and only one was analyzed in more than one article. Irregular beneficial effects of probiotics have been demonstrated in some manifestations of constipation (bowel frequency or consistency of stool or abdominal pain or pain during a bowel movement or flatulence). In one clinical trial, a complete control of constipation without the use of laxatives was obtained.Conclusions: There is no specific pattern of fecal microbiota abnormalities in constipation. Despite the probiotics’ positive effects on certain characteristics of the intestinal habitat, there is still no evidence to recommend it in the treatment of constipation in pediatrics.

Highlights

Constipation is a common clinical occurrence in children and adolescents, with over 90% of cases that classify as functional gastrointestinal disorders.[1,2] The prevalence of constipation varies depending on the diagnostic criteria used, and it is considered to be a public health problem.[3]
12 articles that studied children and adolescents were included in this review.[8,9,13,15,16,17,18,19,20,21,22,23]
The articles were divided into two categories: evaluation of the relationship between fecal microbiota and constipation; and the use of probiotics in the treatment of functional constipation

Summary

Introduction

Constipation is a common clinical occurrence in children and adolescents, with over 90% of cases that classify as functional gastrointestinal disorders.[1,2] The prevalence of constipation varies depending on the diagnostic criteria used, and it is considered to be a public health problem.[3] The Rome criteria are currently adopted to standardize the diagnosis of constipation in the pediatric population.[4,5]. An important role of retention behavior has been evidenced in the pathophysiology of functional constipation, due to unpleasant experiences with bowel movements. Recommended treatment includes a combination of dietary interventions (adequate fiber and fluid intake), education, demystification and, where appropriate, toilet training and completion of a bowel movement diary. In the presence of fecaloma, fecal disimpaction and the use of oral laxatives for prolonged treatment are indicated. The effectiveness and safety of these procedures are well established.[1,5,6]

Methods

Results

Conclusion