title: Effect of synbiotic in constipated adult women - a randomized, double-blind, placebo-controlled study of clinical response.
abstract: OBJECTIVE
  Synbiotic intake may selectively change microbiota composition, restore microbial balance in the gut and improve gastrointestinal functions. We have assessed the clinical response of chronically constipated women to a commercially available synbiotic, combining fructooligosaccharides with Lactobacillus and Bifidobacterium strains (LACTOFOS®).
  
  
  METHODS
  Following 1 week of non-interventional clinical observation, 100 constipated adult women, diagnosed by ROME III criteria, were randomized to receive two daily doses (6 g) of synbiotic or maltodextrin (placebo group), for 30 days. Treatment response was evaluated by patient's daily record of evacuation (stool frequency, consistency and shape, according to Bristol scale), abdominal symptoms (abdominal pain, bloating and flatulence) and constipation intensity (Constipation Scoring System AGACHAN).
  
  
  RESULTS
  Patients treated with synbiotic had increased frequency of evacuation, as well as stool consistency and shape nearer normal parameters than the placebo group, with significant benefits starting during the second and third weeks, respectively (interaction group/time, P<0.0001). There were no significant differences in abdominal symptoms, but AGACHAN score was better in the synbiotic than in the placebo group.
  
  
  CONCLUSIONS
  Dietary supplementation with a synbiotic composed of fructooligosaccharides with Lactobacillus and Bifidobacterium improved evacuation parameters and constipation intensity of chronically constipated women, without influencing abdominal symptoms.
authors.affiliation: University of São Paulo Scholl of Medicine, Department of Gastroenterology, Surgical Gastroenterology Discipline (LIM 35), Sao Paulo, Brazil.
authors.forename: Dan L
authors.initials: DL
authors.lastname: Waitzberg
authors.forename: Luciana C
authors.initials: LC
authors.lastname: Logullo
authors.forename: Amanda F
authors.initials: AF
authors.lastname: Bittencourt
authors.forename: Raquel S
authors.initials: RS
authors.lastname: Torrinhas
authors.forename: Glaucia M
authors.initials: GM
authors.lastname: Shiroma
authors.forename: Natalia P
authors.initials: NP
authors.lastname: Paulino
authors.forename: Maria L
authors.initials: ML
authors.lastname: Teixeira-da-Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001644:Bifidobacterium / Q000254:growth & development; D001938:Brazil; D002908:Chronic Disease; D003248:Constipation / Q000178:diet therapy* / Q000382:microbiology / Q000503:physiopathology; D003672:Defecation; D004311:Double-Blind Method; D005243:Feces / Q000737:chemistry; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology / Q000503:physiopathology*; D006801:Humans; D007778:Lactobacillus / Q000254:growth & development; D008875:Middle Aged; D009844:Oligosaccharides / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index; D058616:Synbiotics / Q000009:adverse effects; D013997:Time Factors; D055815:Young Adult
chemical_list: D009844:Oligosaccharides; C116580:fructooligosaccharide