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Synbiotic supplementation, placebo comparable efficacy in constipated adults, benefits remain in treatment group after cessation

Pank Jit Sin
27 Dec 2017
 The addition of synbiotics to the diet of adults suffering from functional constipation may lead to significant improvement in constipation syndromes. 


According to research by Lim Ying Jie, Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), and colleagues, a 16-week intervention period with synbiotics resulted in improvements in defaecation frequency, stool type (according to Bristol Stool Form Scale) and Patient Assessment of Constipation Symptoms (PAC-SYM) scores. Lim was presenting at the 10th Scientific Seminar on Prebiotics and Probiotics: Role in Promoting Gut Microbiota and Health in Kuala Lumpur recently.

However, no significant difference was noticed between the synbiotics and the placebo groups for constipation symptoms, psychological factors and quality of life. The researchers suggested that the placebo effect may be responsible for this observation as all participants were found to experience improvement on the variables tested.

A participant at the session then shared her experience with the audience, her group also carried out a similar study, with similar results ie, both treatment and placebo groups experienced positive improvements in their constipation symptoms. However, the benefits seen in the placebo group quickly diminished upon cessation of treatment. On the other hand, patients in the treatment group continued to demonstrate positive benefits long after cessation of treatment.

According to Gibson and Roberfroid (1995), synbiotics are a mixture of probiotics and prebiotics that beneficially affect the host by improving the survival and implantation of live microbial dietary supplements in the gastrointestinal tract. [J Nutr. 1995;125(6):1401–1412] This is achieved by selective growth stimulation and/or activation of the metabolism of one or a limited number of health-promoting bacteria—thus improving host welfare.  


Bifidobacterium longum BB536 significantly improves constipation, QoL

Patients with functional constipation, as determined by the ROME III criteria, experience significant improvements in quality of life as measured by the Patient Assessment of Constipation Quality of Life (PAC-QOL) scores when given soy products enriched with probiotic bacterium Bifidobacterium longum bb536.

The study, which was carried out by Associate Professor Loh Su Peng and colleagues, looked into the effect of a soy-based Bifidobacterium longum bb536-inoculated food product on constipation among adult subjects in UPM. Loh is from UPM’s Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences.

Participants of the randomized, double-blind, placebo-controlled study were divided into two groups—the intervention group being given soy formula with probiotics and the control group given soy formula alone. The participants were told to consume two sachets of the formula every day for 4 weeks and their constipation severity (as defined by the ROME III criteria and PAC-QOL scores) were measured.

The intervention group reported significant improvements in physical discomfort, psychosocial discomfort, worries and concerns and increase in satisfaction. On the other hand, those without probiotic supplementation reported no significant improvements across all monitored outcomes.
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Most Read Articles
Tristan Manalac, 2 days ago
Of the newly identified genetic loci for primary angle-closure glaucoma (PACG), two are significantly associated with primary angle-closure suspect (PACS), indicating involvement in the earlier stages of the disease, a recent Singapore study has shown.
5 days ago
Use of proton pump inhibitors (PPIs), even at higher cumulative levels, does not increase the risk for dementia, a recent study has shown.
11 Feb 2018
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5 days ago
Persons with congenital heart disease (CHD) are at a higher risk of dementia, particularly early-onset dementia, than the general population, a recent study has shown.