Gut Microbiota and Chronic Constipation: A Review and Update.

Area of Science:

• Gastroenterology
• Microbiology
• Microbiome Research

Background:

• Chronic constipation, including functional constipation and IBS-C, is common but poorly understood.
• Gut microbiota dysbiosis has been increasingly implicated in chronic constipation.
• Recent studies utilize 16S rRNA profiling to investigate gut microflora alterations.

Purpose of the Study:

• To review recent research on gut microbiota in chronic constipation.
• To summarize findings on treatments for chronic constipation involving probiotics, prebiotics, synbiotics, antibiotics, and FMT.

Main Methods:

• Conducted PubMed searches up to August 1, 2018.
• Used keywords related to chronic constipation, IBS-C, functional constipation, gut microbiota, dysbiosis, and various therapeutic interventions.
• Included randomized controlled trials and parallel-group studies.

Main Results:

• Findings on gut microbiota in functional constipation are inconsistent; no consensus exists.
• IBS-C patients show reduced Actinobacteria (e.g., Bifidobacteria) and increased Bacteroidetes compared to controls.
• Probiotics, prebiotics, synbiotics, antibiotics, and FMT generally demonstrated efficacy with few side effects in trials, though study sizes and probiotic types varied.

Conclusions:

• Gut microbiota dysbiosis is a potential contributor to functional constipation and IBS-C.
• Targeting dysbiosis with interventions like probiotics, prebiotics, synbiotics, antibiotics, and FMT offers a new therapeutic avenue.
• These microbiome-focused treatments may be particularly beneficial for refractory constipation cases.