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Probiotics for Childhood Constipation

By Jessica Patella, ND abstracted from “Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study,” in the 2011 issue of Nutrition Journal.

Key words: Probiotics, Constipation, Children, Bifidobacterium breve

It is estimated the prevalence of chronic constipation in children may be as high as 22.5% (1). Chronic constipation is characterized by less than three bowel movements per week, more than two episodes of fecal incontinence per week and the passage of large painful stools (2). One major cause is often due to the child withholding stools because of a previous painful bowel movement (1,2). Recent research shows the probiotic Bifidobacterium breve may help children suffering with chronic constipation (2).

The standard treatment for pediatric chronic constipation is toilet training and oral laxatives. Yet, after 6-12 months of this treatment, only 50% of children show recovery and are successfully taken off laxatives (3). Additionally, 50% of children using laxatives experience adverse side effects, such as: abdominal pain, bloating, flatulence, diarrhea, nausea and bad taste. And there are no studies evaluating the long-term effects of laxative use in children, such as electrolyte imbalance, mucosal lining damage and habituation (2).

Recent research included 20 children from ages 4-13 (2). For four weeks, the children took one sachet of powder containing 108-10CFU Bifidobacterium breve. All children were instructed to try to defecate on the toilet for 5-10 minutes after each meal (3 times per day) and take bisacodyl (5mg) if they did not have a bowel movement for 3 days (2).

Defecation frequency per week significantly increased from 0.9 to 4.9 (p<0.01).
The average stool consistency score significantly increased from 2.6 to 3.5 (p=0.03).
Episodes of fecal incontinence per week significantly decreased from 9.0 to 1.5 (p<0.01).
Pain during defecation significantly decreased from 71% to 33% (p=0.08).
Abdominal pain episodes per week significantly decreased from 4.2 to 1.9 (p=0.01).
Bisacodyl was used by 45% during week 1 and decreased to 20% by week 4.
No adverse side effects (nausea, diarrhea, bad taste, or increased flatulence) were reported.

In conclusion, this research shows that intake of Bifidobacterium breve for four weeks is an effective treatment for childhood constipation (2). This was a small pilot study, meaning it was not randomized and there was not a placebo control; however, it shows encouraging results. A larger randomized controlled trail is now required to confirm the results.

Jessica Patella, ND, is the founder of Sarasota Natural Health LLC and specializes in homeopathic medicine. She offers a holistic approach to health, inspiring and empowering her clients to lead lives of optimal health and wellness. To learn more, visit www.sarasotanaturalhealth.com

REFERENCES:

1. Pediatric Constipation. Emedicine. http://emedicine.medscape.com/article/928185-overview
2. Tabbers MM, et al. Is Bifidobacterium breve effective in the treatment of childhood constipation? Results from a pilot study. Nutr J 2011, 10:19
3. Pijpers MA, et al. Functional constipation in children: a systemic review on prognosis and predictive factors. J Pediatr Gastroenterol Nutr 2010, 50: 256-268.