Probiotics against childhood constipation
Tijsseling I.A.

Probiotics, friendly bacteria with known benefits for intestinal health, may boost the number of bowel movements and relieve constipation, suggests a new pilot study from the Netherlands.

Writing in the Nutrition Journal, researchers from the Academic Medical Centre in Amsterdam report state that previous studies with single strains showed conflicting results, and that a mixture of Lactobacillus and Bifidobacteria strains may hold the key.

"Given their safety profile, probiotics could be an attractive compound to manipulate gastrointestinal motility in constipated children," wrote lead author Noor Bekkali.

"Based on the results of our pilot study we hypothesise that a mixture of bifidobacteria and lactobacilli producing lactic, acetic and other acids resulting in a lowering of pH in the colon are effective in enhancing motility of the colon, subsequently leading to a decrease in colonic transit time," he added.

The new pilot study investigated the potential of a probiotic mixture to alleviate the symptoms associated with childhood constipation, a condition that can affect up to 30 per cent of children in the Western world, said the researchers.

Twenty constipated children (50 per cent male, average age 8) were recruited for the study and assigned to receive a daily probiotic supplement (Ecologic Relief, Winclove Bio Industries BV, The Netherlands) containing a mixture of Bifidobacteria bifidum, B. infantis, B. longum, Lactobacilli casei, L. plantarum and L. rhamnosus.

The probiotic mix, containing four billion colony forming units, was consumed by the children for four weeks. Prior to the start of the study the subjects were given an rectal enema to promote rectal disimpaction.

Bekkali and co-workers reported that the frequency of bowel movements doubled over the weeks following the start of probiotic supplementation, increasing from two per week to 4.2 after two weeks, to 3.8 after four weeks.

Moreover, a decrease in abdominal pain reported by the children was recorded, going from 45 per cent at the start of the study to only 20 per cent after four weeks of supplementation.

"This non randomised non placebo controlled pilot study evaluating the effect of a mixture of probiotics, showed beneficial effects on symptoms of constipation and a decrease of abdominal pain," stated the researchers.
"Therefore a randomised placebo controlled trial is now required to confirm these data," they concluded.

Source: Nutrition Journal 2007, 6:17 "The role of a probiotics mixture in the treatment of childhood constipation: a pilot study" Authors: N. Bekkali, M.E.J. Bongers, M.M. Van den Berg, O. Liem, M.A. Benninga