Abstract
Objective: Chronic functional constipation is a frequent condition. The aim of the study was to evaluate the efficacy of the probiotic Lactobacillus (L.) reuteri DSM 17938 and magnesium oxide (MgO) for relieving chronic functional constipation in children. Study design: A prospective, double-blind, placebo-controlled, randomized, and parallel-group trial was conducted in five pediatric outpatient clinics in Japan. Sixty patients who were more than six months old and under six years of age with a diagnosis of functional constipation according to Rome IV criteria were randomly divided into three groups: group A (n = 20) received L. reuteri DSM 17938 and lactose hydrate as a placebo of MgO; group B (n = 19) received L. reuteri DSM 17938 and MgO; and group C (n = 21) received a placebo of L. reuteri DSM 17938 and MgO. Results: All three groups exhibited significant improvement in defecation frequency in the fourth week compared with the baseline condition (group A: p < 0.05; group B: p < 0.05; group C: p < 0.05). The MgO group and combination group showed a significant decrease in stool consistency, but the L. reuteri DSM 17938 group did not (group A: p = 0.079; group B: p < 0.05; group C: p < 0.05). MgO significantly suppressed the presence of the genus Dialister. Defecation frequency negatively correlated with the frequency of Clostridiales-belonging bacteria among the gut microbiome. Conclusions: L. rueteri DSM 17938 and MgO were both effective in the management of functional constipation in young children. MgO caused an imbalance in the gastrointestinal microbiome, which was not the case in the probiotic group.
Highlights
Functional constipation is one of the most common gastrointestinal disorders in childhood.The worldwide prevalence of symptoms of constipation in children varies, with an estimated range of0.3%−28% [1]
Probiotics have long been generally considered to provide benefits in functional constipation, few randomized clinical trials have evaluated the effects of probiotics, and data that support the role of probiotics, especially in children with functional chronic constipation, are limited and contradictory [4]
Our results showed that both had an effect on the defecation frequency, and magnesium oxide (MgO) improved stool consistency
Summary
Functional constipation is one of the most common gastrointestinal disorders in childhood.The worldwide prevalence of symptoms of constipation in children varies, with an estimated range of0.3%−28% [1]. Functional constipation is one of the most common gastrointestinal disorders in childhood. The treatments are mainly based on empiricism, and little evidence is available concerning the long-term efficacy. The pathophysiology of functional constipation is multi-factorial and is poorly understood at present. An important cause of constipation arises from intrinsic defects in the colonic function during the process of defecation [2]. Probiotics have long been generally considered to provide benefits in functional constipation, few randomized clinical trials have evaluated the effects of probiotics, and data that support the role of probiotics, especially in children with functional chronic constipation, are limited and contradictory [4]. The evidence concerning comparisons between probiotics and placebo or other laxative medications is scarce and of poor quality [5,6]
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