Strong evidence for synbiotics and constipation relief
The 12-week trial saw 100 patients with slow transit constipation given either the synbiotic BIFICOPEC containing a combination of pectin fibre and Enterococci, Bifidobacteria, Lactobacilli or a placebo of maltodextrin twice daily.
The results published in the journal Nutrients show clinical remission rates reached 37.5% at week four and 45.8% at week 12 in the synbiotic group, compared to just 13.3% at week four and 16.7% at week 12 in the placebo group.
Over the 12 weeks, 64.6% of the patients given synbiotics saw a clinical improvement, compared to just 29.2% of the patients in the placebo group.
The synbiotics group experienced increased stool frequency, improved stool consistency, decreased colonic transit time (CTT) and improved constipation-related symptoms.
“This randomised, placebo-controlled trial suggested that dietary supplementation with a synbiotic improved evacuation-parameters-associated symptoms and colonic motility in patients with slow transit constipation (STC),” wrote the authors from the Jinling Hospital at the Medical School of Nanjing University and the Zhejiang University in China.
Novel therapies needed
Past research has estimated chronic constipation affects almost 16% of all adults worldwide, with women and the elderly particularly perceptible.
Most sufferers of chronic constipation are given laxatives or prokinetic agents to alleviate symptoms empirically.
Yet these current treatments are far from perfect.
“Although there is a wide range of medications, many patients are still dissatisfied with their current treatments, according to the results of a long-term survey, due to insufficient efficacy and some adverse effects,” the researchers wrote.
One paper published this year reported side effects such as abdominal cramps, rash, excessive flatulence and dizziness for patients using the new pharmacotherapy for chronic constipation prucalopride.
“From our clinical experience in constipation, laxatives or other agents could be efficient at the beginning of chronic constipation, but they gradually become largely ineffective. Therefore, novel effective therapies are still needed,” the researchers added.
In the EU there are a few approved fibre health claims concerning stool frequency.
In January last year the European Food Safety Authority (EFSA) backed a claim for prebiotic giant Beneo's chicory-based fibre inulin and improved bowel function.
The same year EFSA gave the thumbs up to DuPont's claim that its bulk sweetener lactitol can help people maintain normal defecation.
However there has been no movement on health claims for probiotics, which remains a banned term in Europe without an approved claim.
8(10), 605; doi:10.3390/nu8100605
“Efficacy of Synbiotics in Patients with Slow Transit Constipation: A Prospective Randomized Trial”
Authors: C. Ding, X. Ge, X. Zhang, H. Tian, H. Wang, L. Gu, J. Gong, W. Zhu and N. Li