Is a multispecies probiotic mixture effective in constipation during pregnancy? 'A pilot study'

Van, De, Tabbers, Benninga

Description

Constipation during pregnancy is a common problem. Nowadays only few effective interventions are published preventing or treating constipation during pregnancy. However, their use is limited due to side-effects. This uncontrolled intervention study was performed to determine if a mixture of probiotics in the treatment of constipation during pregnancy is effective. Methods Women aged ≥ 18 years with functional constipation were included at the Obstetrical outpatient clinic and midwife practices. Patients received during four weeks a daily dose of Ecologic®Relief ( Bifidobacterium bifidum W23 , Bifidobacterium lactis W52 , Bifidobacterium longum W108 , Lactobacillus casei W79 , Lactobacillus plantarum W62 and Lactobacillus rhamnosus W71 (total 4*10 9 CFU)). For all analyses, the non-parametric paired Wilcoxon test was used. Primary outcome measure was change in defecation frequency. Secondary outcome measures were stool consistency, sensation of incomplete evacuation, sensation of anorectal obstruction, manual manoeuvres to facilitate defecation, abdominal pain, adverse effects, presence of reflux episodes and intake of Bisacodyl. Results 20 women were included. Defecation frequency significantly increased from 3.1 at baseline to 6.7 in week four (p < 0.01). Compared to baseline, a significant decrease in 1) sensation of anorectal obstruction from 90.0% to 45.0% (p < 0.01), 2) sensation of incomplete evacuation from 90.0% to 40.0% (p < 0.01), 3) straining during defecation from 100% to 65% (p = 0.01), 4) episodes of abdominal pain from 60% to 20% (p = 0.01) and 5) the presence of reflux episodes from 60% to 20% in week four (p = 0.01) was found. Other secondary outcomes did not decrease significantly. No side effects were reported. Conclusions Ecologic®Relief is effective in the treatment of constipation during pregnancy. A randomised placebo controlled trial is required to confirm these data.

Sujets

• Probiotic
• Constipation
• Pregnancy

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 16
• Langue: English

Extrait

de Millianoet al. Nutrition Journal2012,11:80 http://www.nutritionj.com/content/11/1/80

R E S E A R C HOpen Access Is a multispecies probiotic mixture effective in constipation during pregnancy? 'A pilot study' 1 1*2 1 Inge de Milliano , Merit M Tabbers, Joris A van der Postand Marc A Benninga

Abstract Background:Constipation during pregnancy is a common problem. Nowadays only few effective interventions are published preventing or treating constipation during pregnancy. However, their use is limited due to sideeffects. This uncontrolled intervention study was performed to determine if a mixture of probiotics in the treatment of constipation during pregnancy is effective. Methods:Women aged≥18 years with functional constipation were included at the Obstetrical outpatient clinic W and midwife practices. Patients received during four weeks a daily dose of EcologicRelief (Bifidobacterium bifidum W23, Bifidobacterium lactisW52, Bifidobacterium longumW108, Lactobacillus caseiW79, Lactobacillus plantarumW62 9 andLactobacillus rhamnosusW71 (total 4*10CFU)). For all analyses, the nonparametric paired Wilcoxon test was used. Primary outcome measure was change in defecation frequency. Secondary outcome measures were stool consistency, sensation of incomplete evacuation, sensation of anorectal obstruction, manual manoeuvres to facilitate defecation, abdominal pain, adverse effects, presence of reflux episodes and intake of Bisacodyl. Results:20 women were included. Defecation frequency significantly increased from 3.1 at baseline to 6.7 in week four (p< 0.01).Compared to baseline, a significant decrease in 1) sensation of anorectal obstruction from 90.0% to 45.0% (p< 0.01),2) sensation of incomplete evacuation from 90.0% to 40.0% (p< 0.01),3) straining during defecation from 100% to 65% (p= 0.01),4) episodes of abdominal pain from 60% to 20% (p= 0.01)and 5) the presence of reflux episodes from 60% to 20% in week four (p= 0.01)was found. Other secondary outcomes did not decrease significantly. No side effects were reported. W Conclusions:is effective in the treatment of constipation during pregnancy. A randomised placeboEcologic Relief controlled trial is required to confirm these data. Keywords:Probiotics, Constipation, Pregnancy

Background The reported prevalence of constipation in pregnant women varies between 1138% and occurs mostly during the third trimester, although symptoms can also be present from 12 weeks gestation [14]. According to the ROME III criteria constipation is characterised by strain ing during defecation, lumpy or hard stools, sensation of incomplete evacuation or anorectal obstruction, manual manoeuvres to facilitate defecation, and/or less than three defecations per week [5]. At physical examination,

* Correspondence: [e-mail] 1 Department of Paediatric Gastroenterology and Nutrition, Emma Children’s Hospital/ Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Full list of author information is available at the end of the article

a palpable faecal mass is often found in the abdomen or the rectum [6,7]. The pathophysiology underlying functional constipa tion is undoubtedly multifactorial and not well under stood. Progressively rising progesterone and estrogen levels have been suggested as cause of constipation dur ing pregnancy [3,8,9]. Animal studies have shown that these female hormones, particularly progesterone, inhibit gut smooth muscle thereby decreasing esophageal, gas tric, and colonic muscle contractility [3,10]. Low fluid and fibre intake may also play a role. It has been sug gested that pregnant women consume less fibres than recommended for the nonpregnant population, how ever this assumption has not yet been confirmed [11,12].

© 2012 de Milliano et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.