First study of its kind explores potential of probiotic + prebiotic to ease constipation in kids with cerebral palsy

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“The most common gastrointestinal alteration in children with cerebral palsy is constipation at a prevalence of 74%,” stated the study authors. Image © Tetiana Lazunova / Getty Images (Getty Images/iStockphoto)

A combination of a probiotic plus a prebiotic may easy constipation measures in children with cerebral palsy (CP), a group that suffers from a high prevalence of constipation, says a new study from Mexico.

Supplements of Limosilactobacillus reuteri DSM 17938 (formerly Lactobacillus reuteri*) plus inulin from agave were associated with significant improvements in stool characteristics, while the probiotic alone was associated with improvements in intestinal motility and lower pH of the stool, according to findings published in Nutrients.

On the other hand, agave inulin improved stool consistency, reported scientists from Instituto Tecnológico y de Estudios Superiores Monterrey Campus Guadalajara, Universidad de Guadalajara, and the Universidad de Colima.

“This is the first double-blind randomized controlled clinical trial to analyze the efficacy of a probiotic and/or a prebiotic in the treatment of constipation in children with CP,” they wrote.

“Longitudinal studies are crucial to evaluate the effect of probiotic and prebiotic treatments with a longer intervention as well as using different combinations of prebiotics with L. reuteri DSM 17938 to determine the best substrate that favors the growth of lactic acid bacteria.”

Study details

For the new study, the Mexico-based researchers recruited 37 children with cerebral palsy and chronic constipation  and randomly assigned them to one of four groups: A placebo group; a probiotic only group (100 million colony forming units (cfu) of L. reuteri DSM 17938); a prebiotic only group (4 g of agave inulin); or the combination of prebiotic plus probiotic).

The results showed that, after 28 days, probiotic, prebiotic, and synbiotic groups showed a significant improvement in the history of excessive stool retention, the presence of fecal mass in the rectum, and the history of painful defecation.

In addition, the probiotic-only group showed a significant decrease in stool pH. “This could be attributed to the reuterin produced by L. reuteri, an antimicrobial substance that inhibits the adhesion of pathogens to the intestinal epithelium,” explained the researchers.

On the other hand, improvements in stool consistency were recorded in the prebiotic group

“The use of L. reuteri DSM 17938 and agave inulin is an effective alternative to improve stool characteristics and constipation in children with CP. L. reuteri DSM 17938 improved intestinal motility and acidified stool pH, while agave inulin improved stool consistency, but when analyzed together, they did not show the same effect,” wrote the scientists.

Source: Nutrients

2020, 12(10), 2971; doi: 10.3390/nu12102971

“Lactobacillus reuteri DSM 17938 and Agave Inulin in Children with Cerebral Palsy and Chronic Constipation: A Double-Blind Randomized Placebo Controlled Clinical Trial”

Authors: A. A. García Contreras et al.

* An international working group published taxonomic changes to the genus Lactobacillus in April 2020. The reclassification led to renaming of many species. The University of Alberta offers a tool, which is available HERE, to allow stakeholders to quickly search the old names to discover the new names.