Probiotics in Alleviating Constipation: Mechanisms, Strain Screening, and Applications

Area of Science:

• Gastroenterology and Microbiology
• Microbial Therapeutics

Background:

• Constipation is a common gastrointestinal disorder with few effective treatments.
• Probiotics show potential but require strain-specific efficacy data and mechanistic clarity for clinical use.

Purpose of the Study:

• To systematically review evidence on probiotic interventions for constipation.
• To identify effective strains, elucidate mechanisms, and propose a screening framework.

Main Methods:

• Systematic synthesis of human randomized controlled trials, animal studies, and mechanistic investigations.
• Cataloging anti-constipation strains and summarizing meta-analysis findings.
• Analyzing probiotic mechanisms including microbiota modulation, metabolite actions, gut-brain axis, and mucosal barrier.

Main Results:

• Specific strains like B. coagulans, L. paracasei, and L. reuteri demonstrate significant efficacy in improving constipation symptoms.
• Probiotics act via gut microbiota modulation, SCFA/5-HT production, gut-brain axis regulation, and mucosal barrier restoration.
• A four-stage screening pipeline for strain selection is proposed.

Conclusions:

• Evidence supports specific probiotic strains for constipation management.
• Mechanistic insights guide the development of personalized probiotic therapies.
• The proposed framework facilitates evidence-based strain selection for constipation.