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Saccharomyces boulardii and Lactulose for Childhood Functional Constipation: A Multicenter Randomized Controlled
Kyung Jae Lee1,2, Eell Ryoo3, Yoo Min Lee4
1Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Gangwon-do, Korea.
Journal of Neurogastroenterology and Motility
|July 7, 2022
Summary
Saccharomyces boulardii monotherapy is less effective for childhood functional constipation than lactulose or combination therapy. This probiotic showed lower success and maintenance rates, supporting current treatment recommendations.
Area of Science:
- Pediatrics
- Gastroenterology
- Microbiology
Background:
- Probiotic efficacy in children varies by disease and strain.
- Functional constipation is a common pediatric condition.
- Investigating specific probiotics for constipation is crucial.
Purpose of the Study:
- To evaluate the effectiveness of Saccharomyces boulardii and lactulose for childhood functional constipation.
- To compare monotherapy with combination therapy.
Main Methods:
- An open-label randomized controlled trial involving 187 children with functional constipation.
- Three groups: lactulose monotherapy, combination therapy, and S. boulardii monotherapy.
- Primary outcome: treatment success rate at 12 weeks (≥3 bowel movements without incontinence).
Main Results:
- Lactulose monotherapy (26.1%) and combination therapy (41.2%) showed significantly higher success rates than S. boulardii monotherapy (8.0%).
- S. boulardii monotherapy had lower cumulative successful maintenance and drug maintenance rates.
- No significant differences in stool frequency, incontinence, or painful defecation at week 2.
Conclusions:
- Saccharomyces boulardii monotherapy is not superior to lactulose or combination therapy for childhood functional constipation.
- Higher drug change rates observed with S. boulardii monotherapy.
- Findings support current probiotic recommendations for pediatric constipation.
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