Probiotics and Constipation

We usually think of bacteria as harmful germs but many bacteria actually help our body function properly. Probiotics (meaning “for life) are thought to improve our health in a number of ways such as by reducing harmful bacteria in the large intestine or by increasing the number of “good” intestinal bacteria.

Many parents give their children products containing probiotics with the belief that probiotics will improve bowel function as well as other GI symptoms and that probiotics are safe.

The fact is that the FDA has not approved any health claims for probiotics and although most people do not experience negative side effects or have only mild side effects, such as gas, there have been case reports of serious adverse side effects.

Remember that probiotics sold as supplements or ingredients in foods cannot legally declare that it can cure, prevent or treat a disease. Always consult with your pediatrician before giving a child probiotics. See Chapter 18 in my book for more information.

Are Probiotics Effective for Functional Constipation?

Earlier this year I attended the 10th International Symposium on Functional Gastrointestinal Disorders held in Milwaukee, Wisconsin. This symposium brings together many of the leading GI researchers and clinicians from around the world to present their findings.

One of the hot topics these days is the role of intestinal bacteria in human nutrition and susceptibility to disease. There are over 100 million bacteria in our skin and mouth, but mostly in our intestines, that may predispose us to a range of chronic diseases.  Unfortunately, there are not many related interventions that have been proven effective.

One fascinating success, though unrelated to constipation, is "fecal transplants" which involves transplanting a healthy person’s stool (and therefore healthy bacteria) into a sick person’s gut (colon).  It has been shown to effectively treat Clostridium difficile infection (CDI), which produces antibiotic resistant intestinal bacteria.

However, there is still no known connection between functional constipation and any specific bacteria or group of bacteria. Without knowing which bacteria might be involved in functional constipation, the value of probiotics (live bacteria supplements that may provide health benefits) in the treatment of functional constipation is unclear.

That said, preliminary studies have shown that probiotics or combinations of probiotics may improve intestinal functioning (e.g. transit time and frequency of bowel movements) and may, therefore, be helpful in preventing or treating occasional childhood constipation. 

A few of my patients have described some success using probiotics with their children to encourage bowel movements. While we wait for more definitive scientific studies, the moderate use of probiotics is certainly worth a try!