Effectiveness of a Probiotic for Functional Chronic Constipation: A Meta-analysis of Randomized Controlled Trials

Context: The metabolic effects of Lactobacillus reuteri DSM 17938 administration in the treatment of functional chronic constipation are unknown. Objectives: The purpose of this review is to investigate the function of L. reuteri DSM17938 in bowel movements and stool consistency in children and adults diagnosed with functional chronic constipation. Methods: Five electronic databases were used to search for the English version of Randomized Controlled Trials (RCTs) published between 2000 and 2018 that investigated the metabolic functions of 4-8 weeks of a dietaryL. reuteri DSM17938 intervention in children and adults diagnosed with functional chronic constipation. The risk of bias was evaluated in eligible studies, and a random-effects model was used to perform a meta-analysis for qualitative and quantitative analyses. Results: Five high-quality RCTs involving 737 participants were included in the review. L. reuteri DSM 17938 supplementation was effective in increasing bowel movements (mean difference =1.12; 95% CI 0.85,1.39, P < 0.00001) in patients with functional chronic constipation. However, no significant differences in stool consistency from baseline were observed following L. reuteri DSM 17938 supplementation (0.98; 95% CI 0.66,1.44, P = 0.90). Conclusions: There were significant differences in bowel movements between the experimental and placebo groups, and no significant differences in stool consistency. In addition, there were no adverse effects of the L. reuteri DSM 17938 treatment reported. These results demonstrate the beneficial effects of L. reuteri DSM 17938 in functional chronic constipation patients in comparison with placebo.