Efficacy of a probiotic-prebiotic mix on chronic constipation symptoms in the elderly: results of a pilot study

Constipation affects about 25% of the general population, with higher prevalence in elderly people. Many of the products used for the treatment of constipation, laxatives and drugs with this indication have undesirable effects such as dehydration, electrolyte disturbances and diarrhea or side effects that, in frail patients with comorbidities, such as the elderly, can have clinically significant consequences. For these reasons, the treatment of chronic constipation constitutes, especially in the elderly patient, a partial unmet medical need.

This interventional, single-arm pilot study evaluated efficacy and safety of a probiotic-prebiotic combination in elderly patients with chronic constipation. The probiotics included Lactobacillus rhamnosus, Lactobacillus paracasei, Bifidobacterium animalis ssp. lactis, and Bifidobacterium breve. Treatment lasted 28 consecutive days.

Fifty elderly patients (average age 65.3 years) with chronic constipation participated. At baseline, 72% of patients reported ≤2 complete spontaneous bowel movements (CSBM) per week. After the treatment, 36% of patients reported ≤2 CSBMs/week (P=0.023), 64% experienced improvement of 1-4 CSBMs/week. Quality of Life (QoL) related to abdominal pain, bloating, and constipation improved. No adverse events were reported.

This real-world study suggests that probiotic-prebiotic combinations can rapidly improve bowel transit and constipation symptoms, potentially reducing dependence on laxatives and enemas while improving QoL. A longer-term randomized controlled trial is needed to confirm these findings.