07/05/06 05:40 PM
Probiotics Help Chronic Constipation

The pathogenesis of constipation remains to be completely defined, although the condition is commonly categorized as normal-transit constipation, pelvic floor dysfunction, and slow-transit constipation. The role of bacteria in the generation of constipation symptoms has begun to receive considerable attention, and one report has shown an association between excess methane production and slow colonic transit. In an interesting study involving 22 patients with slow-transit constipation documented by radio-opaque markers, Schlieger and colleagues randomized subjects to receive either Lactobacillus casei (6.5 x 109 colony forming units/day) or placebo for 4 weeks. Measurement of colonic transit time was repeated after 4 weeks. Patients in the Lactobacillus group had an objective improvement in colonic transit time from 95.6 hours to 77 hours (P < .05), primarily due to more rapid transit through the rectosigmoid colon. Patients in the placebo group noted a slight reduction in transit time as well (from 93.7 hours to 87.1 hours), although this was not statistically significant.

The study authors did not report symptom response and did not report whether colonic transit time worsened after Lactobacillus treatment had stopped. Future studies are needed to verify this finding and determine the relationship between probiotic use and colonic transit.

Pimentel M, Mayer AG, Park S, Chow EJ, Hasan A, Kong Y. Methane production during lactulose breath test is associated with gastrointestinal disease presentation. Dig Dis Sci. 2003;48:86-92. Abstract

Schlieger F, Krammer H, Franke A, Harder H, Wagner I, Singer MV. Effect of lactobacillus casei shirota on colonic transit time in patients with slow-transit constipation. Gastroenterology. 2006;130:A-289. [#S1938]


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