Constipation problems increase as intestinal microbiota and gut function change with aging, the researchers wrote in their systematic review, published in the journal Archives of Gerontology and Geriatrics.
“This can become a very important issue in western societies where many people are now living longer lives,” they added.
Thus, the administration of probiotics or prebiotics may be a promising approach for addressing gastrointestinal alterations, “and can have many beneficial effects on the body besides constipation and other gastrointestinal disorders.”
Collecting data
The researchers looked at existing scientific evidence that explored the link between beneficial microorganisms on gut health, specifically in an elderly study sample.
They collected studies from the databases Medline, Embase, Scopus, Lilacs, and Cochrane for all entries the end of 2015. Primary search terms used were ‘constipation’ and ‘probiotics,’ and included those that were randomized controlled trials or observational studies, specifically assessed constipation after intervention, and involved study participants aged 60 years or more.
Out of 475 potential studies, 15 met the inclusion criteria to be analysed in detail, with finally nine articles fulfilling all criteria and aims of the review.
Strains in the studies
The pooled studies had 778 participants, both men and women, in the age range of 65-102 years. Intervention periods varied from 2 weeks to 6 months.
Various species were used in different interventions. For example, the study by Van den Nieuwboer et al (2015), which studied 44 participants aged 74-99 for six weeks, looked at the effect of consuming Lactobacillus casei Shirota in the finished product Yakult Original on stool quality and bowel movements.
Another study, by Yeun & Lee (2015), looked at a multispecies probiotic product with three Bifidobacterium species, two Lactobacillus species, and Streptococcus thermophiles delivered in the branded supplement Doulac Care.
The strain of bacteria most commonly tested in the pooled studies was Bifidobacterium longum.
‘Administration of probiotics produced a small but significant effect’
When bowel movements or stool appearance are considered as the main outcomes, the analyses of all RCTS in the systematic review “suggest that the administration of probiotics produced a small but significant effect,” the researchers wrote.
The positive and significant effects on bowel movement reported after intervention with a probiotic supplement ranged between 10 and 30% compared to placebo controls, though measurement had some limitations.
“Evaluating this variability was impossible because of the features of the study population i.e. elderly patients hospitalised in a geriatric orthopaedic rehabilitation centre (Zaharoni et al., 2011), long term inpatients receiving enteral nutrition (Kondo et al., 2013), or elderly nursing home residents (Pitkala et al., 2007),” they wrote.
To further develop understanding of link between probiotics and constipation in an elderly population, future studies should focus on evaluating the extent of constipation using clinically demonstrated methods, the researchers argued.
But in this first systematic review of its kind, the researchers added that “the specific strain(s) of probiotics used, and the particular populations in which they are applied (i.e. in individuals without severe neurodegenerative diseases) play an important role in the efficacy of probiotic treatments for constipation, and thus should be thoroughly examined in further specifically-designed studies.”
Source: Archives of Gerontology and Geriatrics
Published online ahead of print, https://doi.org/10.1016/j.archger.2017.04.004
The effect of probiotics as a treatment for constipation in elderly people: A systematic review
Authors: Maria Isabel Martínez-Martínez, Raquel Calabuig-Tolsá, Omar Cauli