Network meta-analysis of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults

Deng, Xinxin1,2,3; Liang, Cui1,2,3; Zhou, Liying1,2,3; Shang, Xue4; Hui, Xu2,3; Hou, Liangying2,3; Wang, Yongsheng1,2,3; Liu, Wendi1,2,3; Liang, Shanshan1,2,3; Yao, Liang5; Yang, Kehu2,3; Li, Xiuxia1,2,3

2024-05-01

10.1007/s00394-024-03410-1

EUROPEAN JOURNAL OF NUTRITION   影响因子和分区

1436-6207

1436-6215

ObjectiveTo compare the outcomes associated with the use of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults.MethodsWe searched eight electronic databases from database inception to July 11, 2023, to identify randomized controlled trials (RCTs) that report efficacy and safety for the treatment of chronic constipation. The risk of bias in the included RCTs was evaluated according to the Cochrane tool, and the certainty of the evidence was assessed using the Confidence in Network Meta-Analysis framework. The analysis was conducted using R version 4.3.0.ResultsOut of the 37 RCTs, a total of 21 different types of interventions were reported, involving 3,903 patients. This NMA demonstrated that both prebiotics and synbiotics resulted in an increase in frequency of stool movements per week. Compared to placebo, lactulose (Mean difference [MD] = 3.39, 95% Confdence interval [CI] [1.13, 5.65], moderate certainty), mix2 (consisting of Lactulose and Bacillus coagulans) (MD = 3.63, 95% CI [1.37, 5.89], moderate certainty), mix6 (consisting of Lactulose and Bifidobacterium coagulans) (MD = 4.30, 95% CI [1.04, 7.54], low certainty), and mix7 (consisting of Lactulose, Bifidobacterium subtilis, and Enterococcus faecium) (MD = 4.58, 95% CI [1.35, 7.78], moderate certainty) exhibited a significant effect. Notably, mix7 demonstrated the highest probability of being the most effective intervention (94.8%). Furthermore, when compared to L. plantarum, four probiotics and two synbiotics showed significant advantages in the Patient Assessment of Constipation Symptoms (PAC-SYM) score. L. reuteri (MD = -13.74, 95% CI [-22.20, -4.66], very low certainty) exhibited a significant effect in improving the Patient Assessment of Constipation Quality of Life (PAC-QoL) score. In terms of safety, there were no statistically significant differences between the intervention and control groups in all adverse event analyses.ConclusionsModerate to very low evidence supports the use of lactulose and synbiotics to increase the number of weekly stool movements in patients, particularly highlighting the significant impact of synbiotics in increasing the number of weekly stool movements in patients with constipation. The use of L. paracasei showed improvements in PAC-SYM scores, while L. reuteri demonstrated enhancements in PAC-QoL scores.

Constipation Probiotic Prebiotic Synbiotic Network meta-analysis Systematic review Adults

SCI

英语

其他

Nutrition & Dietetics

Nutrition & Dietetics

WOS:001216793600002

SPRINGER HEIDELBERG

CLINICAL MEDICINE

Web of Science

1.Lanzhou Univ, Hlth Technol Assessment Ctr, Evidence Based Social Sci Res Ctr, Sch Publ Hlth, 199 Donggang West Rd, Lanzhou 730000, Peoples R China
2.Lanzhou Univ, Evidence Based Med Ctr, Sch Basic Med Sci, 199 Donggang West Rd, Lanzhou 730000, Peoples R China
3.Key Lab Evidence Based Med & Knowledge Translat Ga, Lanzhou 730000, Peoples R China
4.Southern Univ Sci & Technol, Sch Publ Hlth & Emergency Management, Shenzhen, Peoples R China
5.McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

Deng, Xinxin,Liang, Cui,Zhou, Liying,et al. Network meta-analysis of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults[J]. EUROPEAN JOURNAL OF NUTRITION,2024.

Deng, Xinxin.,Liang, Cui.,Zhou, Liying.,Shang, Xue.,Hui, Xu.,...&Li, Xiuxia.(2024).Network meta-analysis of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults.EUROPEAN JOURNAL OF NUTRITION.

Deng, Xinxin,et al."Network meta-analysis of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults".EUROPEAN JOURNAL OF NUTRITION (2024).