*EMBARGOED All research presented at the World Congress of Gastroenterology at ACG2017 is strictly embargoed until Monday, October 16, 2017, at 8:00 am EDT.
Poster 695 Probiotics to Treat Chronic Constipation in Children: A Cochrane Systematic Review
Author Insight from Morris Gordon, MBChB, MMed, PhD, University of Central Lancashire
What’s new here and important for clinicians?
This review was presented two years ago and publication delayed by an unprecedented 40% increase in the number of published randomized trials within just two years. This reflects the massive interest in the area of constipation and the use of probiotics.
The key elements to highlight for clinicians is that study quality was general good. Additionally, the probiotics were used in some studies as primary therapy and in some as an add-on to laxative therapy. The evidence appears to show they are more effective than placebo, although due to the two separate types of use (primary vs. add-on therapy), the number of studies in each meta-analysis was relatively low. Additionally, no statistically significant safety concerns were found overall or in any individual study. Collectively, these results suggest that probiotics may be an agent to be used in this context, although future work in both contexts may be needed to add to the robustness of the evidence base and to also look at long-term impact.
What do patients need to know?
Probiotic are potentially beneficial bacteria. Many studies have suggested they may have a role in improving constipation in both adults and children. In this systematic review looking at constipation in children, completed to the highest quality standards in the field (Cochrane), the agents have been found to be more effective than no intervention or placebo when subjected to combined analysis (meta-analysis). However, as there are two ways to use the probiotics, as a single therapy or add-on to laxatives, more studies may be needed to confirm these results. No safety concerns were found in any individual trials or collectively. As these agents are often available without prescription to patients as “food supplements,” patients may find these results of particular interest.
Morris Gordon, MBChB, MMed, PhD, University of Central Lancashire
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