title: Change of Fecal Flora and Effectiveness of the Short-term VSL#3 Probiotic Treatment in Patients With Functional Constipation.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Seong-Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Wonkwang University School of Medicine, Iksan, Jeollabuk-do, Korea.
authors.forename: Suck Chei
authors.initials: SC
authors.lastname: Choi
authors.affiliation: Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Park
authors.affiliation: Kosin University College of Medicine, Busan, Korea.
authors.forename: Moo In
authors.initials: MI
authors.lastname: Park
authors.affiliation: Dankook University College of Medicine, Cheonan, Chungcheongnam-do, Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Shin
authors.affiliation: Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Lee
authors.affiliation: University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Kee Wook
authors.initials: KW
authors.lastname: Jung
authors.affiliation: Konyang University College of Medicine, Daejon, Korea.
authors.forename: Hoon Sup
authors.initials: HS
authors.lastname: Koo
authors.affiliation: University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Myung
keywords: Constipation; Microbiome; Probiotics