Effect of Lactobacillus Reuteri in Children with Chronic Functional Constipation: A Double-Blind Randomized Clinical Trial

Abstract

This double-blind, randomized clinical trial investigated the efficacy of Lactobacillus reuteri in treating chronic functional constipation in children aged 2 to 14 years. Constipation, affecting up to 25% of the pediatric population, is often functional in nature and challenging to manage with standard treatments such as laxatives and dietary modifications. Given the emerging interest in probiotics, this study aimed to evaluate the potential of Lactobacillus reuteri as a complementary treatment alongside polyethylene glycol (PEG). Eighty children diagnosed with chronic functional constipation were randomly assigned to receive either Lactobacillus reuteri DSM 17938 or a placebo, in combination with PEG. Participants were monitored over 7 weeks, with assessments conducted on bowel movement frequency, stool consistency, straining during defecation, abdominal pain, and fecal incontinence. Results demonstrated that the probiotic group experienced significant improvements in bowel movement frequency (mean increase of 2.4 ± 1.1 per week) compared to the placebo group (1.2 ± 0.9; p < 0.001). Secondary outcomes, including stool consistency, straining, and abdominal pain, as well showed notable improvements in the probiotic group. Additionally, fecal incontinence episodes decreased more in the probiotic group than in the placebo group (p = 0.008), with fewer adverse events reported. In conclusion, Lactobacillus reuteri combined with PEG significantly improved constipation symptoms, offering a safe and effective adjunctive therapy for children with chronic functional constipation. These findings suggest that incorporating probiotics into conventional treatment protocols may enhance clinical outcomes and improve the quality of life for pediatric patients.