The Effect of Lactobacillus reuteri Supplementation in Adults with Chronic Functional Constipation: a Randomized, Double-Blind, Placebo-Controlled Trial*

2014 ◽  
Vol 23 (4) ◽  
pp. 387-391 ◽  
Author(s):  
Veronica Ojetti ◽  
Gianluca Ianiro ◽  
Annalisa Tortora ◽  
Giovanna D‘Angelo ◽  
Teresa Antonella Di Rienzo ◽  
...  
Keyword(s):  
Bowel Movement ◽  
Lactobacillus Reuteri ◽  
Controlled Trial ◽  
Functional Constipation ◽  
Stool Consistency ◽  
Double Blind ◽  
Movement Frequency ◽  
Bowel Movements ◽  
Bowel Movement Frequency ◽  
The Mean

Background & Aims: There is a growing interest for the use of probiotics for chronic constipation. A recent randomized controlled trial (RCT) showed a positive effect of Lactobacillus reuteri (L. reuteri) on bowel movement frequency in infants with chronic constipation. The aim of the present study was to evaluate the effects of L. reuteri in adult patients with functional constipation.Methods: A double-blind, placebo RCT was conducted in 40 adults (18M/22F, 35±15 years) affected by functional constipation according to the Rome III criteria. Patients were randomly assigned to receive a supplementation of L. reuteri (DSM 17938), or matching placebo for 4 weeks. The increase of bowel movements/week was the primary outcome, while the improvement of stool consistency was the secondary outcome.Results: At week 4, the mean increase in bowel movements/week was 2.6 (SD±1.14, 95% CI:1.6-3.6) in the L. reuteri group and 1.0 (SD±1. 95% CI:0.12-1.88) in the placebo group (p=0.046). At the end of the treatment, the mean bowel movements/week was 5.28±1.93 in the L. reuteri group and 3.89±1.79 in the placebo group. There was a not significant difference in the stool consistency between the two groups.Conclusions: L. reuteri is more effective than the placebo in improving bowel movement frequency in adult patients with functional constipation as previously demonstrated in children, even if it seems to have no effect on stool consistency.

scholarly journals Parkinson’s Disease-Related Motor and Nonmotor Symptoms in the Lancaster Amish

2020 ◽  
Vol 54 (5) ◽  
pp. 392-397
Author(s):  
Michael D.F. Goldenberg ◽  
Xuemei Huang ◽  
Honglei Chen ◽  
Lan Kong ◽  
Teodor T. Postolache ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Daytime Sleepiness ◽  
Bowel Movement ◽  
Motor Symptoms ◽  
Nonmotor Symptoms ◽  
Case Identification ◽  
Movement Frequency ◽  
Bowel Movements ◽  
Bowel Movement Frequency

<b><i>Introduction:</i></b> Previous research has suggested that the Amish may experience a relatively high prevalence of Parkinson’s disease (PD) and/or parkinsonian motor signs. <b><i>Methods:</i></b> In a large sample from the Amish community in Lancaster County, Pennsylvania, age ≥18 years, we assessed the prevalence of self-reported PD diagnosis. For those without self-reported PD diagnosis, we assessed the frequency of PD-related motor symptoms using a 9-item questionnaire that was designed by the PD Epidemiology Research Group. Lastly, we queried study participants for the presence of 2 nonmotor symptoms that have been commonly linked to PD: bowel movement frequency and daytime sleepiness. <b><i>Results:</i></b> Among 2,025 subjects who answered the PD questionnaire, 430 were older than 60 years. Of 430 participants ≥60 years, 5 (1.2%) reported a PD diagnosis. Of those without a PD diagnosis, 10.5% reported ≥1 and 1.2% ≥ 4 motor symptoms for the 9-item PD screening questionnaire. Of the 3,789 subjects who answered the question about bowel movement frequency, 0.7% reported ≤3 bowel movements per week. Among 1,710 subjects who answered the question about daytime sleepiness, 8.1% of the participants reported “always” sleepy during the day. <b><i>Discussion:</i></b> These data neither support a markedly higher PD prevalence in the older Lancaster Amish nor do they show dramatically higher motor and/or selected nonmotor symptoms than the general population. Future studies that employ more rigorous procedures for case identification and PD-specific preclinical symptoms/tests are needed to determine the potential differences and similarities among different Amish populations and between Amish and non-Amish populations.

scholarly journals Evaluation of meaningful change in bowel movement frequency for patients with carcinoid syndrome

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Stacie Hudgens ◽  
John Ramage ◽  
Matthew Kulke ◽  
Emily Bergsland ◽  
Lowell Anthony ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effect Size ◽  
Carcinoid Syndrome ◽  
Bowel Movement ◽  
Life Questionnaire ◽  
Meaningful Change ◽  
Movement Frequency ◽  
Bowel Movements ◽  
Bowel Movement Frequency

Abstract Background Carcinoid syndrome is associated with a reduced quality of life that can be attributed to symptoms such as diarrhea and fatigue as well as social and financial issues. This study was conducted to psychometrically assess meaningful change in bowel movement frequency among carcinoid syndrome patients using data from the TELESTAR clinical study. Methods An anchor-based approach for deriving meaningful change thresholds consisted of mapping change from baseline bowel movement frequency to other patient-reported assessments of change. These included the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire - Core Questionnaire (QLQ-C30) Diarrhea Symptom responders, the EORTC Gastrointestinal NET questionnaire (GI.NET21) GI Symptom responders, and reported adequate relief at Week 12 (≥ 10-point score decrease from Day 1 to Week 12). Parameters included within-group mean change from baseline to Week 12, t-tests of the change (Wilcoxon rank sum for adequate relief), and effect size. Results There were 135 carcinoid syndrome patients with a mean baseline frequency of 5.7 bowel movements a day. A distribution-based method yielded meaningful change estimates of 0.62 bowel movements a day for overall frequency and 0.83 bowel movements a day at Week 12. Anchor-based analysis indicated a large effect size among patients who reported adequate relief at Week 12 (− 1.58; n = 18; P = 0.014), the QLQ-C30 Diarrhea domain responders (− 1.24; n = 40; P < 0.001), and the GI.NET21 GI Symptoms Domain responders (− 1.49; n = 25; P = 0.005). Exit interview data for meaningful change yielded effect size estimates of − 1.57 for overall change during the Double-blind Treatment Period and − 1.97 for change between Baseline and Week 12. Conclusions Meaningful change derivation is critical to interpret patient outcomes for evaluating treatment efficacy. In this study, carcinoid syndrome patients experienced clinically meaningful reductions in bowel movement frequency of ≥30% over 12 weeks with telotristat ethyl treatment. Trial registration NCT01677910.

Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation

2018 ◽  
Vol 9 (1) ◽  
pp. 51-60 ◽  
Author(s):  
G. Riezzo ◽  
A. Orlando ◽  
B. D’Attoma ◽  
M. Linsalata ◽  
M. Martulli ◽  
...  
Keyword(s):  
Lactobacillus Reuteri ◽  
Controlled Trial ◽  
Functional Constipation ◽  
Colonic Transit ◽  
Gas Content ◽  
Bowel Habit ◽  
Gut Health ◽  
Double Blind ◽  
Standard Dosage ◽  
Double Blind Clinical Trial

Dysbiosis may contribute to constipation and its symptoms, therefore probiotic administration could improve significantly gut health and functions. The aim of the study was to investigate the effects of a long-lasting administration of Lactobacillus reuteri DSM 17938 (LR DSM 17938) on symptoms and quality of life (QoL) score in patients with functional constipation (FC). 56 FC patients with normal colonic transit time and without anorectal disorders and pelvic floor dysfunctions completed the study. LR DSM 17938 was administered for 105 days in a randomised double-blind clinical trial (28 patients per arm). Individual and cumulative scores including the Constipaq, a modified Constipation Scoring System (CSS) that considers the patient assessment of constipation-QoL (PAC-QoL), were calculated during the preliminary visit (V0), at day 15 (end of the induction period with a LR DSM 17938 double dosage, 4×108 cfu), day 60 (intermediate evaluation) and day 105 (V4) after a standard dosage (2×108 cfu). At the end of treatment, the beneficial effect of LR DSM 17938 compared to placebo was significantly evident for symptoms related to gas content and dysbiosis (abdominal discomfort, pain and bloating), incomplete defecation and helps for defecation (P<0.05). At the end of the whole LR DSM 17938 treatment, a marked and positive effect on both the CSS single and the cumulative items was evident with the exception of unfruitful attempt and Bristol score. Present findings indicate that LR DSM 17938 has an effect on symptoms different from stool consistency, and they suggest that this probiotic can effectively be used in association therapy rather than as single-drug therapy in the management of FC.

scholarly journals Timing and Frequency of Bowel Activity in Patients Ingesting Sodium Picosulphate/Magnesium Citrate and Adjuvant Bisacodyl for Colon Cleansing Before Colonoscopy

2011 ◽  
Vol 25 (12) ◽  
pp. 663-666 ◽  
Author(s):  
Stephen Vanner ◽  
Lawrence C Hookey
Keyword(s):  
Bowel Preparation ◽  
Bowel Movement ◽  
Magnesium Citrate ◽  
Split Dose ◽  
Colon Cleansing ◽  
Sodium Picosulphate ◽  
Bowel Cleansing ◽  
Bowel Movements ◽  
Bowel Movement Frequency ◽  
The Mean

BACKGROUND: Despite the wealth of research investigating bowel cleansing efficacy, there are very little data on the timing or frequency of bowel movements after each agent is ingested.OBJECTIVE: To examine the effect of each component of a three-day combined sodium picosulphate/magnesium citrate (PSLX) and bisacodyl regimen on the timing and frequency of bowel activity in patients undergoing colonoscopy.METHODS: Outpatients booked for colonoscopy were asked to complete a diary of their bowel preparation that tracked the timing of bowel movements. Bowel preparation quality was assessed using the Ottawa Bowel Preparation Scale. Bowel activity was compared with baseline and correlated with colon cleansing. Subgroup analysis was performed examining the effect of timing of the procedure and split-dose regimens.RESULTS: One hundred patients undergoing colon cleansing received bisacodyl 10 mg at 17:00 three days and two days before the day of colonoscopy. In one group, both sachets of PSLX were given the night before colonoscopy, while the second group, whose colonoscopies were scheduled after 11:00, ingested one sachet the night before and the second sachet at 06:00 on the day of colonoscopy. Patients had a mean of 1.7 bowel movements per day in the seven days before starting the cleansing regimen. Both doses of bisacodyl tablets resulted in a significant increase in the mean number of bowel movements compared with baseline (3.3/day first dose; 3.8/day second dose [P=0.03 and 0.001, respectively]). Each dose of PSLX also resulted in a significant increase in bowel movement frequency compared with baseline, with means of 4.4, 6.3 and 4.5 bowel movements after each dose. The mean time to the final bowel movement following the second sachet of PSLX was 8.9 h when taken the night before, and 3.9 h when taken the morning of the procedure. Bowel preparation quality significantly correlated with bowel frequency when total bowel movements were considered and when only the effects of bisacodyl were accounted for (P<0.01 for each).DISCUSSION: These data demonstrate that the addition of bisacodyl before PSLX ingestion has a significant additive effect on bowel frequency and correlates with bowel cleansing quality. The timing of the resulting bowel movements have practical implications for sleep and travel times to endoscopy suites.

Effectiveness of Probiotics in the Management of Functional Constipation in Children: A Randomized, Double-Blind, Placebo-Controlled Trial

2020 ◽  
Vol 15 (1) ◽  
pp. 1-6
Author(s):  
Tjokronegoro Srihati Dyah Permatasari ◽  
Advani Najib ◽  
Firmansyah Agus
Keyword(s):  
Placebo Group ◽  
Controlled Trial ◽  
Functional Constipation ◽  
Parent Report ◽  
Number Needed To Treat ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Bowel Movements ◽  
Rome Iii ◽  
Constipation Severity

A randomized, double-blind, placebo-controlled trial was conducted to assess the efficacy of probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) in 78 children aged 4–10 years old with functional constipation (Rome III criteria) at several schools in Jakarta, Indonesia. The case finding used a validated parent-report questionnaire. Subjects were randomly assigned to receive either oral probiotics (L. acidophilus, B. longum, and S. thermophylus 1 × 109 cfu/day) or placebo twice a day for 4 weeks. There were more subjects in the probiotics group who had improvement in stool consistency (P = 0.022) and difficulty/painful defecation (P = 0.009) than in the placebo group. Other symptoms (frequency of bowel movements, withholding behavior, fecal incontinence, and presence of stool mass in abdomen) also improved, but no statistically significant differences were found. Constipation severity significantly improved in the probiotics group (P = 0.026). Overall improvement (defined as decrease of constipation severity score >60% at the end of evaluation) was higher in the probiotics group than the placebo group (31/39 versus 18/39, P = 0.002) with number needed to treat (NNT) of 3 (95%CI 2;8). The present study shows that probiotics (L. acidophilus, B. longum, and S. thermophylus 2 × 109 cfu/day) are effective in the management of functional constipation in children.

scholarly journals Comparisons between Manual Lymph Drainage, Abdominal Massage, and Electrical Stimulation on Functional Constipation Outcomes: A Randomized, Controlled Trial

2020 ◽  
Vol 17 (11) ◽  
pp. 3924
Author(s):  
Jacqueline S. Drouin ◽  
Lucinda Pfalzer ◽  
Jung Myo Shim ◽  
Seong Jung Kim
Keyword(s):  
Electrical Stimulation ◽  
Controlled Trial ◽  
Low Frequency ◽  
Functional Constipation ◽  
Total Power ◽  
Lymph Drainage ◽  
Manual Lymph Drainage ◽  
Movement Frequency ◽  
Bowel Movement Frequency ◽  
Abdominal Massage

Background: Evidence supports abdominal massage (AM) or electrical stimulation (ES) as effective in treating functional constipation (FC). Manual lymph drainage (MLD) may also be beneficial, however, it was not previously investigated or compared to ES and AM. Methods: Sixteen college-aged males and 36 females were recruited. Participants were randomly assigned to MLD, AM or ES. Heart rate variability (HRV) measures for total power (TP), high frequency (HF), low frequency and LF/HF ratio assessed ANS outcomes. state-trait anxiety inventory (STAI) and stress response inventory (SRI) assessed psychological factors and bowel movement frequency (BMF) and duration (BMD) were recorded daily. Results: MLD significantly improved all ANS measures ( p ≤ 0.01 ); AM significantly improved LF, HF and LF/HF ratios (p = 0.04); and ES significantly improved LF (p = 0.1). STAI measures improved, but not significantly in all groups. SRI improved significantly from MLD (p < 0.01), AM (p = 0.04) and ES (p < 0.01), but changes were not significant between groups. BMD improved significantly in all groups ( p ≤ 0.02). BMF improved significantly only following MLD and AM (p < 0.1), but differences between groups were not significant (p = 0.39). Conclusions: MLD significantly reduced FC symptoms and MLD had greater improvements than AM or ES.

The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: a double blind, randomised, placebo controlled 2-week trial

2019 ◽  
Vol 10 (6) ◽  
pp. 617-627 ◽  
Author(s):  
K. Airaksinen ◽  
N. Yeung ◽  
A. Lyra ◽  
S.J. Lahtinen ◽  
T. Huttunen ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Gastrointestinal Symptoms ◽  
Area Under The Curve ◽  
Functional Constipation ◽  
Colonic Transit ◽  
Primary Analysis ◽  
Double Blind ◽  
Probiotic Group ◽  
Intention To Treat ◽  
Bowel Movement Frequency

Selected strains of lactobacilli and bifidobacteria are known to ameliorate constipation-related symptoms and have previously shown efficacy on digestive health. In this clinical trial, the safety and effectiveness of a probiotic blend containing lactobacilli and bifidobacteria were evaluated in adults with self-reported bloating and functional constipation. Constipation was diagnosed by the Rome III criteria. A total of 156 adults were randomised into this double-blind and placebo-controlled trial. Participants consumed the combination of Lactobacillus acidophilus NCFM (1010 cfu), Lactobacillus paracasei Lpc-37 (2.5×109 cfu), Bifidobacterium animalis subsp. lactis strains Bl-04 (2.5×109 cfu), Bi-07 (2.5×109 cfu) and HN019 (1010 cfu) (n=78), or placebo (microcrystalline cellulose) (n=78) for two weeks. After treatment the following were measured: primary outcome of bloating and secondary outcomes of colonic transit time, bowel movement frequency, stool consistency, other gastrointestinal symptoms (flatulence, abdominal pain, and burbling), constipation-related questionnaires (PAC-SYM and PAC-QoL) and product satisfaction. Faecal recovery of consumed strains was determined. The enrolled population was defined as constipated, however, the initial bloating severity was lower than in previous similar studies. No clinically significant observations related to the safety of the product were reported. Product efficacy was not shown in the primary analysis for bloating nor for the secondary efficacy analyses. The placebo functioned similarly as the probiotic product. In post-hoc analysis, a statistically significant decrease in flatulence in favour of the probiotic group was observed; day 7 (intention-to-treat (ITT): P=0.0313; per-protocol (PP): 0.0253) and on day 14 (ITT: P=0.0116; PP: P=0.0102) as measured by area under the curve (AUC) analysis. The mean AUC of all symptoms decreased in favour of the probiotic group, indicating less digestive discomfort. The study was registered at the ISRCTN registry (ISRCTN41607808).

scholarly journals Superiority of mosapride citrate to picosulfate sodium as a laxative for withdrawal from regular enemas in children with severe functional constipation

2021 ◽  
Vol 8 (9) ◽  
pp. 331-334
Author(s):  
Yoshimitsu Fujii ◽  
Eriko Kouhata ◽  
Kazunari Kaneko
Keyword(s):  
Magnesium Oxide ◽  
Bowel Movement ◽  
Functional Constipation ◽  
Observational Period ◽  
Mosapride Citrate ◽  
Stimulant Laxative ◽  
Movement Frequency ◽  
Bowel Movement Frequency ◽  
Treatment Naïve ◽  
Rome Iv

Background: Severe functional constipation (FC) with low bowel movement frequency (BMF) of ?1 day/week and hard stools oftenrequires regularly repeated enemas or often leads to enema dependency (ED). Aim: The current study aimed to compare the efficacy of mosapride citrate (Mo) with the traditional stimulant laxative picosulfate sodium (Pi) for withdrawal from ED in children with severe FC. Results: Twenty-four treatment-naïve patients who met the Rome IV diagnostic criteria for FC seen at our center for 8 years from 2012 were enrolled. Glycerin enema was repeated until the BMF was ?3.5 days/week. Simultaneously, Mo at 0.3 mg/kg/day (n=11) or Pi at 0.25 mg/kg/day (n=13) was administered concomitantly with magnesium oxide or lactulose. The proportion of withdrawal from ED was significantly higher in the Mo group than Pi group during the 4 months observational period (90.9% vs. 46.2%, respectively; p=0.034) and shorter in time to withdraw from ED (0 vs. 3.5 months, respectively; p=0.015). Conclusion: Mo is more effective than Pi for withdrawal from ED in children with severe FC.

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