Microbiota-A Rescuing Modulator in Children Struggling with Functional Constipation.

2025-06-27
Microorganisms 13(7)
- Nicoleta Ana Tomșa
- Lorena Elena Meliț
- Teodora Popescu
- Karina Najjar
- Anca Meda Văsieșiu
- Adrian Vlad Pop
- Reka Borka-Balas

PubMed: 40732011
DOI: 10.3390/microorganisms13071504

Study Design

Type: Review

Constipation affects around 30% of children and in 95% of cases is functional (FC), a consequence of alterations in digestive tract peristalsis, modulated by the immune and nervous systems, bile acid metabolism, and the gut microbiota. The aim of this review was to assess the role of gut microbiota and the use of probiotics in children with constipation. The current treatment involves education, toilet training, and oral laxatives, effective in only 50% of patients. In chronic FC, the composition of the microbiota is altered, with increased abundance of Bacteroidetes, Enterobacteriaceae, and Firmicutes and decreases in Prevotella, Bifidobacteria, Faecalibacterium prausnitzii, and Clostridium leptum. Probiotics replenish lacking beneficial resident bacteria, downregulate mucosal inflammation, or produce short-chain fatty acids (SCFAs). Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain. Bifidobacterium animalis subsp. lactis XLTG11 improves the gut microbiota by upregulating SCFA genes and downregulating those related to methane metabolism. Lactobacilli produce organic acids that stimulate bowel peristalsis and augment fecal bolus moisture. The heterogeneity of the current studies involving pediatric subjects thus far hinders the use of probiotics as a standard in the management of children with constipation.

Research Insights

Bifidobacterium breve→Increased Defecation Frequency
Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain.
Effect
Beneficial
Effect size
Moderate
Bifidobacterium breve→Reduced Abdominal Pain
Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain.
Effect
Beneficial
Effect size
Moderate
Bifidobacterium breve→Reduced Fecal Incontinence Episode
Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain.
Effect
Beneficial
Effect size
Moderate
bifidobacterium longum→Increased Defecation Frequency
Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain.
Effect
Beneficial
Effect size
Moderate
bifidobacterium longum→Reduced Abdominal Pain
Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain.
Effect
Beneficial
Effect size
Moderate
bifidobacterium longum→Reduced Fecal Incontinence Episode
Probiotics like Bifidobacterium breve and Bifidobacterium longum increase the defecation frequency and decrease the episodes of both fecal incontinence and abdominal pain.
Effect
Beneficial
Effect size
Moderate