Change of Fecal Flora and Effectiveness of the Short-term VSL#3 Probiotic Treatment in Patients With Functional Constipation

• Published in: Journal of neurogastroenterology and motility Vol. 21; no. 1; pp. 111 - 120
• Main Authors: Kim, Seong-Eun, Choi, Suck Chei, Park, Kyung Sik, Park, Moo In, Shin, Jeong Eun, Lee, Tae Hee, Jung, Kee Wook, Koo, Hoon Sup, Myung, Seung-Jae
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Neurogastroenterology and Motility 01.01.2015; 대한소화기 기능성질환∙운동학회
• Subjects: Original; 내과학; Probiotics; Constipation; Microbiome
• ISSN: 2093-0879; 2093-0887
• DOI: 10.5056/jnm14048

We investigated gut flora characteristics in patients with functional constipation (FC) and influences of short-term treatment with VSL#3 probiotic on flora and symptom improvement. Thirty patients fulfilling Rome III criteria for FC and 30 controls were enrolled. Fecal samples were obtained before and after VSL#3 intake (one sachet twice daily for 2 weeks) and flora were examined by quantitative real-time polymerase chain reaction (qRT-PCR). Symptom changes were also investigated. The fold differences in Bifidobacterium and Bacteroides species were significantly lower in feces from FC, compared to in controls (P = 0.030 and P = 0.021). After taking VSL#3, the fold differences in Lactobacillus, Bifidobacterium and Bacteroides species increased in controls (P = 0.022, P = 0.018, and P = 0.076), but not in FC. Mean Bristol scores and complete spontaneous bowel movements (CSBMs)/week increased significantly in FC after ingesting VSL#3 (both P < 0.001). Relief of subjective CSBM frequency, stool consistency and abdominal bloating were reported in 70%, 60%, and 47% of patients. After VSL#3 cessation, 44.4% of patients with symptom improvement experienced constipation recurrence mostly within one month. Bifidobacterium and Bacteroides species might be quantitatively altered in FC. A short-term VSL#3 treatment can improve clinical symptoms of FC. Further studies are needed to investigate VSL#3's additional effects beyond altering gut flora to allevate constipation.