Ojetti Veronica, Ianiro Gianluca, Tortora Annalisa, D'Angelo Giovanna, Di Rienzo Teresa Antonella, Bibbò Stefano, Migneco Alessio, Gasbarrini Antonio
Department of Medical Sciences, Division of Gastroenterology Catholic University Rome, Italy.
J Gastrointestin Liver Dis. 2014 Dec;23(4):387-91. doi: 10.15403/jgld.2014.1121.234.elr.
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.
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.
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.
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.
益生菌用于慢性便秘的治疗越来越受到关注。最近一项随机对照试验(RCT)表明,罗伊氏乳杆菌(L. reuteri)对慢性便秘婴儿的排便频率有积极影响。本研究的目的是评估罗伊氏乳杆菌对成年功能性便秘患者的影响。
根据罗马III标准,对40名成年功能性便秘患者(18名男性/22名女性,35±15岁)进行了双盲、安慰剂RCT。患者被随机分配接受罗伊氏乳杆菌(DSM 17938)补充剂或匹配的安慰剂,为期4周。每周排便次数的增加是主要结局,而粪便稠度的改善是次要结局。
在第4周时,罗伊氏乳杆菌组每周排便次数的平均增加为2.6(标准差±1.14,95%置信区间:1.6 - 3.6),安慰剂组为1.0(标准差±1,95%置信区间:0.12 - 1.88)(p = 0.046)。治疗结束时,罗伊氏乳杆菌组每周平均排便次数为5.28±1.93,安慰剂组为3.89±1.79。两组之间的粪便稠度没有显著差异。
如先前在儿童中所证明的,罗伊氏乳杆菌在改善成年功能性便秘患者的排便频率方面比安慰剂更有效,即使它似乎对粪便稠度没有影响。