Effect of probiotic + laxatives for improving functional constipation in children

Probiotics, with or without laxatives enhance bowel movement frequency with Protexin with laxatives being the most effective for children with functional constipation.

Constipation affects 0.7% to 29.6% of children globally, with 95% being functional. This network meta-analysis (NMA) compares the efficacy and acceptability of different probiotic supplements for treating pediatric functional constipation.

This frequentist model-based NMA examined randomized controlled trials evaluating probiotic supplements for functional constipation in children. The changes in bowel movement or frequency were specified as the primary outcome, while discontinuation rates were specified as the acceptability outcome.

The analysis included nine RCTs with 710 children (average age: 5.5 years; almost half were females). Most probiotic interventions, whether used alone or in conjunction with laxatives, showed significantly greater improvement in bowel movement frequency compared to placebo.

Protexin combined with laxatives demonstrated the most substantial improvement (standardized mean difference (SMD) = 1.87, 95% confidence interval (CI) = 0.85 to 2.90). Among single probiotic treatments, only Lactobacillus casei rhamnosus Lcr35 exhibited significant efficacy compared to placebo or control. Additionally, all probiotic interventions had comparable rates of faecal/bowel incontinence and patient dropout compared to placebo.

Combined probiotics and laxatives may be beneficial for treating pediatric functional constipation, provided there are no contraindications.