The role of probiotics in the treatment of functional constipation in children and adolescents - own observations

Introduction: Functional constipation has been defined by the III Roman criteria. Its background is usually functional, and only in a small percentage of cases an organic cause is found. Constipation is treated by cleansing the intestine from feces, and then working out a correct pattern of the child's defecation through non-pharmacological recommendations and pharmacological therapy. Aim of the study: To assess the efficacy of different strains of probiotic bacteria used in the treatment of functional constipation along with dietary and/or pharmacological interventions. Material and methods: The analysis of the medical documentation of 221 patients diagnosed with functional constipation according to the III Roman criteria. The patients were divided into two groups: - group A, contained patients for whom probiotic preparations were included in the treatment, - group B, contained patients treated without probiotics. The impact of the type of probiotic strain and the type of therapeutic intervention was analyzed. More frequent defecation, better stool consistency, less episodes of undergarments soiling, and less painful defecation during the first 3 months of the treatment were considered as indicators of improvement. Results: Improvement of defecation was observed, irrespective of the applied treatment, in 45 of 95 patients in group A (47%), and in 57 of 126 patients in group B (45%). Differences between groups A and B were statistically insignificant (p>0.05). The most frequently applied probiotic strain was Lactobacillus rhamnosus GG - 57% (n=54) and Lactobacillus rhamnosus along with Lactobacillus acidophilus - 27% (n=26). Improvement of defecation in over a half (58%) of the patients receiving the probiotics was observed. The differences were statistically insignificant. Conclusion: The application of probiotics (Lactobacillus rhamnosus, Lactobacillus acidophilus, Lactobacillus rhamnosus GG, Lactobacillus delbrueckii subsp., Bifidobacterium bifidum, and Bifidobacterium infantis) does not improve defecation in patients with functional constipation.