Synbiotics' anti-constipation effects require more specific evidence: Malaysia population study
Researchers at the university conducted a randomised, double-blind, placebo-controlled study among 85 constipated adults to assess the impact of a synbiotic supplement containing 10 billion CFU (colony-forming units) of Lactobacillus plantarum LP01, Bifidobacterium lactis BB12, and inulinoligofructose on their condition.
Among the participants, 43 received the 2.5g of the supplement and the remaining 42 received 2.5g of placebo once a day, taken every morning for 12 weeks.
The researchers conducted a follow-up every fortnight, with participants' response to treatment assessed using a questionnaire that covered a record of evacuation (stool frequency, stool type according to the Bristol Stool Form Scale), Patient’s Assessment on Constipation Syndrome (PAC-SYM), and Patient’s Assessment on Constipation Quality of Life (PAC-QOL).
They also measured functional constipation symptoms such as defecation frequency, stool type, and PAC-SYM scores.
Synbiotic supplementation a success?
They reported "no significant differences" in stool evacuation, but noted that the stool type and frequency of defecation in the treatment group had improved "tremendously", compared to the placebo group.
When it came to PAC-QOL scores, the treatment group saw a 33.2% improvement, compared to 17% in the placebo group.
In terms of PAC-SYM scores, on the other hand, "tremendous decreases" were noted in both groups — the synbiotics group experienced a 49.6% decrease, while the placebo group experienced a 43.7% in PAC-SYM scores.
At the same time, the participants in the treatment group were said to have experienced greater reduction in the severity of their functional constipation symptoms. However, the differences between them and those in the placebo group were not statistically significant.
Still, the improvements observed in the placebo group might have been the result of variation in the participants' daily diet, such as lower consumption of spicy foods, as well as changes in their level of physical activity, quality of life, and psychological factors.
Synbiotics — a combination of probiotics and prebiotics — have been found to possess several gut health benefits, especially for young children.
A Danone study conducted in Thailand found that a synbiotic mixture improved toddlers' faecal microbiota, while a Danone expert we interviewed at last year's Probiota Asia said a unique synbiotic combination supported healthy infant gut development.
However, other experts have also said there is insufficient data to back the efficacy of synbiotics on gut health and other aspects of human health.
Missing from the combination
The researchers involved in the current study said varying the treatment dosage could have led to different results. They also did not collect faecal samples to assess supplement compliance or examine faecal microbiota and short-chain fatty acids, instead relying on participant feedback.
This meant they were unable to draw any scientific evidence on the compliance and viability of probiotics from the presence of probiotics in the faeces, which would have made for a stronger study observation.
They concluded: "Further randomised, controlled studies are required to affirm whether the synbiotic supplement that contained 10 billion CFU Lactobacillus plantarum LP01, Bifidobacterium lactis BB12, and inulinoligofructose is effective in improving functional constipation symptoms and quality of life as compared with placebo.
"However, the overall findings of the present study seem to support the use of (a) synbiotic supplement to improve functional constipation among the respective individuals, rather than laxatives, which can result in life-threatening complications."
"Effects of Synbiotics among Constipated Adults in Serdang, Selangor, Malaysia—A Randomised, Double-Blind, Placebo-Controlled Trial"
Authors: Ying Jye Lim, et al.