Probiotics May Not Relieve Constipation in Children

According to a new study published in the journal, Pediatrics, probiotics may not improve constipation in children more than any other dairy product that does not contain probiotics. This is different from the effect of probiotics in adults where it is supposed to give good relief from constipation.

In this study, 159 children who had constipation for at least two months were recruited. The defecation rate in the children was less than three times per week. The participants were divided into two groups, and one of the groups was provided with a probiotic product two times a day for three weeks. The second group was given with a dairy product without a probiotic.

The researchers reported that even though probiotics contained B lactis strain DN-173 010 increased the stool frequency, it was not significantly more than the dairy product given in the second group. Study researcher Merit M. Tabbers, MD, PhD, a pediatric gastroenterologist at Emma’s Children’s Hospital Academic Medical Center in Amsterdam, says that there is a general belief that probiotics may improve constipation in children, but the evidence is not strong enough to follow the recommendation of having this product to treat functional childhood constipation.

“Probiotics are commonly given to children with constipation, and this state is generally very difficult to treat in most of the patients”, says Tabbers. “About 50% of the children were found to recover and could avoid the use of laxatives," adds Tabbers. In another study, even after intensive medical and behavioural therapy, about 30% of the patients continued to have severe complaints including constipation; infrequent, painful defecation; and fecal incontinence.

Sandra Fryhofer, MD, an internal medicine specialist in Atlanta, feels that most parents opt for probiotics as a safe and natural remedy as constipation is very uncomfortable for children. Usually the first step of treatment in children is education, dietary advice, and behavioral modifications, and when this does not work laxatives are prescribed. Despite the fact that there is lack of proper evidence to show that it really works, use of probiotics is widely accepted.

Studies on adults have also shown that probiotics containing B lactis DN-173 010 may improve constipation to a certain extent. According to researchers, constipation in children is different from that in adults with respect to prevalence, onset, etiology, symptoms, treatment, and prognosis. They feel that some more studies are required to see whether the use of probiotics may be effective in the treatment of constipation in children with a short history of constipation.