Lactobacillus reuteri DSM 17938 and Agave Inulin in Children with Cerebral Palsy and Chronic Constipation: A Double-Blind Randomized Placebo Controlled Clinical Trial.

Andrea García Contreras,Mary Fafutis Morris,Edgar Vásquez Garibay,Carmen Sánchez Ramírez,Vidal Delgado Rizo

doi:10.3390/nu12102971

Andrea García Contreras, Mary Fafutis Morris + Show 3 more

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https://doi.org/10.3390/nu12102971

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Abstract

The main objective was to assess the efficacy of a probiotic (Lactobacillus reuteri DSM 17938), a prebiotic (agave inulin), and a synbiotic on the stool characteristics in children with cerebral palsy and chronic constipation. Thirty-seven children with cerebral palsy and chronic constipation were included. The probiotic group received 1 × 108 colony forming unit (cfu) of L. reuteri DSM 17938 plus placebo, the prebiotic group received 4 g of agave inulin plus placebo, the synbiotic group received L. reuteri DSM 17938 plus agave inulin, and the placebo group received two placebos for 28 days. The probiotic group showed a significant decrease in stool pH (p = 0.014). Stool consistency improved in the prebiotic group (p = 0.008). The probiotic, prebiotic, and synbiotic groups showed a significant improvement in the history of excessive stool retention, the presence of fecal mass in the rectum, and the history of painful defecation. L. reuteri concentration in feces was higher in the probiotic group than in the placebo group (p = 0.001) and showed an inverse correlation with stool pH in the probiotic group (r = −0.762, p = 0.028). This study showed that the use of L. reuteri DSM 17938 and/or agave inulin improved the stool characteristics such as the history of painful defecation and the presence of fecal mass in the rectum against placebo in children with cerebral palsy and chronic constipation.

Highlights

Cerebral palsy (CP) is defined as a group of permanent disorders affecting the development of movement and posture, causing activity limitation, which are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain [1]
Children were not included when (I) they presented CP of postnatal origin or comorbidities not associated with CP, (II) they were receiving antibiotics, prebiotics, and/or probiotics during the month before the study, and (III) the parents or legal guardians did not agree to participate in the study
There were no significant differences in age, weight, height, body mass index (BMI), and weight/age index at the beginning of the study among the four groups (Table 1)

Summary

Introduction

Cerebral palsy (CP) is defined as a group of permanent disorders affecting the development of movement and posture, causing activity limitation, which are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain [1]. The most common gastrointestinal alteration in children with cerebral palsy is constipation [2] at a prevalence of 74% [3]. Treatment options for constipation are mainly traditional methods such as purgative therapy and surgery [9]; there has been a growing interest in the use of synbiotics, prebiotics, and probiotics. Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to Nutrients 2020, 12, 2971; doi:10.3390/nu12102971 www.mdpi.com/journal/nutrients

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