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Synbiotic Supplementation for Chronic Constipation in Patients Under Peritoneal Dialysis: An Italian Multicenter
Gennaro Argentino1, Giuseppe Paribello2, Andrea Foderini3
1Nephrology Unit of "Ospedale del Mare" Hospital, Napoli, Italy.
Summary
Synbiotic supplementation significantly improved constipation scores and reduced laxative use in peritoneal dialysis patients. This intervention offers a promising approach for managing constipation in this vulnerable population.
Area of Science:
- Nephrology
- Gastroenterology
- Microbiology
Background:
- Chronic constipation is a common complication in patients undergoing peritoneal dialysis (PD).
- Constipation in PD patients increases the risk of catheter malfunction and peritonitis.
- Gut dysbiosis is implicated in worsening constipation among dialysis patients.
Purpose of the Study:
- To evaluate the efficacy of synbiotic supplementation in managing chronic constipation in PD patients.
- To assess the impact of synbiotics on constipation severity and laxative dependence.
Main Methods:
- A prospective, single-arm study was conducted over 16 weeks.
- Participants received synbiotic supplementation containing fructo-oligosaccharides and specific probiotic strains (Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus reuteri, Saccharomyces boulardii).
- Primary endpoints included changes in the constipation scoring system and laxative usage.
Main Results:
- Out of 76 patients with constipation, 70 completed the 16-week study.
- Synbiotic supplementation led to a significant reduction in constipation scores (mean change -5.3; P = .001).
- A substantial proportion of laxative users (36.8% suspended, 42.1% reduced use) experienced decreased reliance on laxatives.
Conclusions:
- Synbiotic supplementation effectively alleviates chronic constipation in PD patients.
- This intervention can lead to a significant reduction in the need for laxative use.
- The benefits of synbiotics were consistent across various patient demographics and clinical characteristics.
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