Probiotics for the Treatment of Constipation


Probiotics are those helpful little bacteria that are so beneficial to human health. We can take them as supplements or as food and beverage. Probiotics are present in yogurt and various other “cultured” foods. We have known of the ability of probiotics to ease and even cure digestive disorders for a long time now. Two of the most common strains in supplement form are Lactobacillus or Bifidobacterium.

The Problem with Constipation Medications

Constipation, the opposite of diarrhea, is a common and often painful problem. In the US alone, the disorder affects around 15 percent of the adult population. Estimates suggest that 3.2 million Americans seek medical treatment in a desperate attempt to unblock themselves. As far as the pharmaceutical industry goes, they're not complaining. Constipation is one gastrointestinal disorder that nets them a tidy sum each year. Some estimates put this somewhere around seven hundred fifty million dollars per annum.

Despite many of the over-the-counter “remedies” not remedying much at all, people still buy them. Most laxatives and stool softeners fail to deliver on their promise, but anything is worth a try.

How Probiotics Help with Constipation

To see how effective probiotics are for constipation we need to look to the science. The most recent research is perhaps the one to come out of King's College in London. Here the researchers compiled a collection of no fewer than 14 studies. All of these 14 studies were clinical trials. Each study randomly assigned people with constipation into groups. They gave one group probiotics and the other volunteers a placebo or some other controlled treatment. Obviously none of the participants knew what the researchers had given them.

Here's what the scientists took from their combined findings:

  • Probiotics slowed “gut transit time” by 12.4 hour (avg)
  • Increased weekly bowel movements by 1.3
  • Helped soften stools, making them easier to pass

The findings above are evidence that probiotics help treat people suffering with constipation [1]

The problem with science is that it's always looking for more proof. Nothing is ever totally conclusive in the eyes of scientist. Lay people don't care too much about what science says though. For people with constipation, they just want relief from the condition. For them, if probiotics work, as probiotics often do, then nothing else matters.

Dr. Allan Walker is the director of the Division of Nutrition at Harvard Medical School. He's also a world-renowned expert in the probiotics field. Despite the findings with the above study, Dr. Walker says there's still not enough evidence. His reason for this is because the findings came about as a collective conclusion of 14 separate, small scale studies.  Each of these studies had different designs and variable results overall. This is why Dr. Walker says it's difficult to recommend a specific probiotic to people with constipation.

Science has to follow a set protocol and principles. For studies to be conclusive, science needs large multicenter trials, with standardized outcomes. This is the only way to determine which probiotic species and strain is most effective for constipation. It would also reveal the most effective dosage and how long they should be taken.

What the Logic Says

Putting science to one side for a moment, let's look at what the logic says. We know that the majority of bacteria that makes up our large intestine are as follows:

  • Bifidobacteria
  • Lactobacillus

Probiotics with specific strains that belong to these species are the most beneficial for helping to reduce constipation. We also know that some probiotics produce lactic acid and short-chain fatty acids (SCFAs). What this does is lower the pH in the colon which heightens muscle contractions (peristalsis) along the large intestine. The result of this is enhanced regularity [2].

We know that some bifidobacterium and lactobacillus species enhance bowel regularity and mucous secretion. It does this by converting bound bile salts into free bile salts. The upshot of this is that these free bile salts result in more water getting pulled into the colon. More water means softer stools and assists easier passing.

How to Choose Probiotics for Constipation

Not all probiotics are equal. Some are renowned for their quality and beneficial effects. Others are cheap, unknown, and often totally useless. This is not an area where you want to go bargain hunting. If you do, you could come away with a product that does nothing of any benefit, thus rendering it hopeless.

Note that each probiotic strain is different from the next. Note also that only certain strains belong to a species of bacteria that carry specific health benefits for constipation. You will only want to go with a product that has been clinically trialled and has proven health benefits. How can you know? Look at real customer reviews and read about the experiences others have said.

What works for one might not necessarily work for another. This is because we can all react in different ways to substances. You will soon get to see which products show the most promise, and then it's just a case of trying for yourself.

For most people, probiotics don’t tend to have any unpleasant side effects. Because of this they and are generally considered safe to use. If you have problems with hardened feces, then you might want to experiment with probiotic supplements. If your problem is ongoing and on your medical records, just let your doctor know what you are taking.

OK, to finish this piece, let's take a look at the probiotic strains that show the most promise for helping to relieve constipation:

Bifidobacterium lactis BB-12

This makes up the majority of bacteria species in the large intestine. It's a well-researched probiotic strain. It's also one that has demonstrated effectiveness when it comes to easing constipation.

Lactobacillus Casei Rhamnosus

This is another dominant bacterium species found in the large intestine. Research has identified this strain as particularly effective for treating children with chronic constipation [3].

Bifidobacterium Animalis

In clinical trials, bifidobacterium animalis subspecies lactis (B. animalis var. lactis)] was able to relieve evacuation disorders and hard stools in healthy adults [4].

Bifidobacterium Longum

Clinical evaluation of a new starter formula for infants looks promising. It contains live Bifidobacterium longum BL999 and prebiotics. The the trials conclude that infants in the experimental group had fewer incidences of constipation. They also had stool characteristics that suggest that the experimental formula was well tolerated [5].

Lactobacillus Plantarum

This is more popular as an effective remedy for relieving IBS symptoms. Even so, it shows some promise for constipation too. In trials, researchers noted a trend towards normalization of stools frequency in constipated patients [6].

Summing Up

A few studies have shown how probiotics can be an effective non-drug cure for constipation. Other studies have been less certain. Anyone with constipation issues has nothing to lose by trying probiotics as a treatment, especially if all else has failed. A good place to start would be to consume probiotic foods at home. If there is little or no improvement, supplements may be the answer as they offer a more therapeutic dose.

Many people have had great results with probiotics for treating their constipation. However, there are others who have not been so fortunate. As yet, there is not a one strain, dosage, duration recommendation as trials are still ongoing. We all react in different ways to various probiotics, which is why the science is a bit clouded.  Because of this, it's just a case of experimenting with the strains outlined in this article until there is enough strong evidence to support solid recommendations.

Resources

  1. http://www.health.harvard.edu/blog/probiotics-may-ease-constipation-201408217377
  2. https://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000097.htm
  3. http://www.ncbi.nlm.nih.gov/pubmed/17587273
  4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198021/
  5. http://www.nutritionjrnl.com/article/S0899-9007%2806%2900359-5/abstract
  6. http://journals.lww.com/eurojgh/Abstract/2001/10000/A_controlled,_double_blind,_randomized_study_on.4.aspx

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