Constipation

Clinical efficacy of non-pharmacological treatment of functional constipation: a systematic review and network meta-analysis.

Tan S, Peng C, Lin X, Peng C, Yang Y, Liu S · Frontiers in cellular and infection microbiology · 2025 · n=4389

The purpose of this study is to compare the relative effectiveness and safety of non-pharmacological interventions for the treatment of functional constipation (FC). We searched Pubmed, Embase, Cochrane, and Web of Science databases for randomized controlled trials published from 2010 to November 2024. The quality of the included studies was evaluated using the Cochrane bias risk tool and Review Manager 5.4, and the evidence was graded using GRADEPro. A network meta-analysis (NMA) was conducted using R Studio, and the surface under the cumulative ranking curve (SUCRA) was used to rank the included drugs for each outcome measure to compare the clinical efficacy of different treatment methods for chronic functional constipation. A total of 29 RCT studies were included, with a total of 4389 patients with functional constipation who were randomly assigned to receive placebo or one of the nine different non-pharmacological treatment methods. The assessment of bias risk showed that the bia

Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD).

Natale P, Green SC, Ruospo M, Craig JC, Vecchio M, Elder GJ · The Cochrane database of systematic reviews · 2025 · n=913

Phosphate binders lower serum phosphate levels for people with chronic kidney disease (CKD). This is an updated review, previously published in 2011 and 2018. New studies have been published and an update of the current evidence is needed. To assess the benefits and harms of phosphate binders for people with CKD and whether phosphate binders have different effects compared with each other. We searched the Cochrane Kidney and Transplant Register of Studies to 16 December 2024 by contacting the Information Specialist, using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, the International Clinical Trials Registry Platform Search Portal, and ClinicalTrials.gov. We included randomised controlled trials (RCTs) or quasi-RCTs of adults with CKD (any glomerular filtration rate; GFR) comparing a phosphate binder to placebo, usual care, or a different phosphate binder with follow-up of at least eight weeks. The key

Meta analysis of clinical efficacy of acupoint application in the treatment of irritable bowel syndrome.

Wang Q, Zhao L, Liu J, Chen L, Zhang B, Zhang Q · African health sciences · 2024 · n=928

The clinical efficacy of acupoint application in the treatment of irritable bowel syndrome (IBS) was evaluated by Meta-analysis. Computer searched Chinese and English databases for the randomized controlled trials (RCTs) and quasi-randomized controlled trials (CCTs) of TCM external therapy, acupoint application, TCM external application, navel sticking and their combination therapy in the treatment of IBS. The search period is from the establishment of the database to December 2022. The literature was screened independently by 2 researchers according to the standard of nano-ranking, and the data of the other 5 researchers were proofread, screened and extracted. After that, the bias risk of the included study was evaluated, and the data were analysed by RevMan 5.4. software. (1) A total of 1842 patients, were included in 25 randomized controlled trials, including the acupoint application treatment group (n=928) and conventional therapy control group (n = 914).(2) The quality of the li

Mediterranean Diet Adherence, Gut Microbiota and Parkinson's Disease: A Systematic Review.

Seelarbokus BA, Menozzi E, Schapira AHV, Kalea AZ, Macnaughtan J · Nutrients · 2024 · n=1213

There is mounting evidence to suggest that high adherence to the Mediterranean diet (MedDiet) may reduce the risk of age-related diseases, including Parkinson's disease (PD). However, evidence for the role of the MedDiet in the relief of motor and non-motor symptoms in patients with PD remains limited and inconclusive. We provide a systematic review of the effects of the MedDiet on the clinical features of PD using data from randomised controlled trials (RCT) and prospective observational studies. We searched MEDLINE, EMCare, EMBASE, Scopus and PubMed from inception until June 2023. Reference lists and the grey literature were also searched. Human studies with no restriction on language or publication date, examining associations between MedDiet adherence and the symptoms of PD, were included. We employed standard methodological procedures for data extraction and evidence synthesis and used the Quality Criteria Checklist for assessing the studies included. Four studies from three uni

Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.

Rebelo F, Mansur IR, Miglioli TC, Meio MDB, Junior SCG · PloS one · 2022

Cerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the quality of life of children with cerebral palsy. Systematically review randomized clinical trials evaluating nutritional and dietary interventions in the clinical, nutritional, and neurodevelopmental aspects of children with cerebral palsy. A search was performed in electronic databases (LILACS, Medline, Web of Science, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Database, OpenGrey) using keywords. The search was firstly performed in May 2020 and updated on June 18th, 2021. Eligible studies were randomized clinical trials, that included children between 2 and 12 years old, and evaluated the effect of nutritional or dietetic inte

Systematic review: probiotics for functional constipation in children.

Wojtyniak K, Szajewska H · European journal of pediatrics · 2017 · n=515

We updated our 2010 systematic review on the efficacy of probiotics in the treatment of constipation in children. The MEDLINE, EMBASE, and Cochrane Library databases; clinical trial registries; and reference lists of included studies were searched to February 2017 for randomized controlled trials (RCTs) performed in children, with no language restriction. The primary outcome measure was treatment success, as defined by the investigators. We included seven RCTs with a total of 515 participants. Included trials were heterogeneous with respect to study population, probiotic strains, dosages, study duration, and follow-up. Pooled results of two RCTs showed no significant difference between the Lactobacillus rhamnosus casei Lcr35 and placebo groups with respect to treatment success. Other probiotics were studied in single trials only. There was no significant difference between the probiotic and control groups with respect to treatment success. While some probiotic strains showed some effec

Randomised controlled trial: nutritional supplements to relieve irritable bowel syndrome symptoms by targeting the gut microbiota.

van den Belt M, Liu Z, Janssen Duijghuijsen L, Zoetendal EG, Witteman B, de Roos NM · Journal of nutritional science · 2025

In individuals with irritable bowel syndrome (IBS), eliminating dietary triggers can alleviate symptoms but may lead to nutrient deficiencies and overall health decline. Although various nutritional supplements show promising results in relieving IBS symptoms due to their potential to alter the microbiome, conclusive scientific evidence remains lacking. This exploratory study aims to assess the bifidogenic properties of four nutritional supplement interventions and their impact on IBS-symptoms, faecal microbiota composition, faecal short-chain fatty acid (SCFA) concentrations, stool pattern, and quality of life (QoL), compared to a placebo control. Seventy subjects with IBS, meeting the ROME IV criteria, participated in this randomised, double-blind, placebo-controlled parallel intervention study. Subjects were assigned to one of the four treatment groups, receiving either resistant starch, pea fibre, chondroitin sulfate, protein hydrolysate, or placebo daily for four weeks. Daily repo

Impact of probiotic supplements on behavioural and gastrointestinal symptoms in children with autism spectrum disorder: A randomised controlled trial.

Narula Khanna H, Roy S, Shaikh A, Chhabra R, Uddin A · BMJ paediatrics open · 2025

To investigate whether probiotic supplementation can improve behavioural and gastrointestinal (GI) symptoms in children with autism spectrum disorder (ASD) aged 2-9 years and further explore the correlation between these symptoms. Single-blinded, randomised, placebo-controlled study. Five developmental paediatric outpatient clinics of 'Continua Kids'. Children aged 2-9 years diagnosed with ASD along with their caregivers. Probiotic or placebo sachet reconstituted in 50 mL of lukewarm milk/water, taken two times per day for 3 months. Change in behavioural (measured by Social Responsiveness Scale-2 (SRS-2) and Aberrant Behaviour Checklist-2 (ABC-2) tools) and GI (measured by GI Severity Index (GSI) score) symptoms after receiving intervention for 3 months. A total of 180 children with ASD were enrolled in the study (probiotic group: 90 and placebo group: 90). All children completed the study. The probiotic group showed a significant reduction in behavioural symptom severity as meas

Acacia fiber or probiotic supplements to relieve gastrointestinal complaints in patients with constipation-predominant IBS: a 4-week randomized double-blinded placebo-controlled intervention trial.

JanssenDuijghuijsen L, van den Belt M, Rijnaarts I, Vos P, Guillemet D, Witteman B · European journal of nutrition · 2024 · n=180

To date, no adequate treatment for irritable bowel syndrome with predominant constipation complaints (IBS-C) is available. Fibers with prebiotic properties and probiotic compounds have shown promise in relieving IBS-C-related complaints. We aimed to determine the effects of a 4-week intervention with either an Acacia fiber (AF) with prebiotic properties or a probiotic Bifidobacterium Lactis (BLa80) supplement, compared to a control supplement, on stool pattern, IBS symptoms and Quality of Life (QoL), in IBS-C individuals. A parallel, double-blind, randomized controlled trial involving 180 subjects meeting the ROME IV criteria for IBS-C was conducted. Following a 4-week observation period, subjects received either AF (10 g), Probiotic BLa80 (4 g; 2 × 1011 CFU/g) or a maltodextrin placebo (10 g) daily for 4 weeks. Subjects reported daily information on stool pattern and gastrointestinal complaints. Before and after each 4-week period, questionnaires on

Medications for Obesity: A Review.

Gudzune KA, Kushner RF · JAMA · 2024 · n=964

Obesity affects approximately 19% of women and 14% of men worldwide and is associated with increased morbidity. Antiobesity medications (AOMs) modify biological processes that affect appetite and significantly improve outcomes, such as type 2 diabetes, hypertension, and dyslipidemia. AOMs should be administered in combination with lifestyle interventions and can be classified according to their mechanisms of action. Orlistat modifies digestive tract absorption and causes gastrointestinal adverse effects, such as oily fecal spotting and urgency, in more than 25% of patients. Centrally acting drugs, such as phentermine-topiramate and naltrexone-bupropion, regulate appetite in the brain and are associated with constipation in approximately 20% of patients, although the incidence of other adverse effects (eg, paresthesia, nausea) varies by medication. Nutrient-stimulated hormone-based medications, such as liraglutide, semaglutide, and tirzepatide, mimic the actions of enteropancreatic hor

Acupuncture in hematologic malignancies and hematopoietic cell transplantation.

El Iskandarani S, Deng G · Blood reviews · 2022

Acupuncture is an integrative medicine modality that has been used historically and studied recently for managing various symptoms and diseases. Patients with hematological malignancies often experience a high symptom burden including pain, fatigue, nausea, vomiting, and insomnia. Pharmacological interventions are the mainstay of managing these symptoms, although they may not provide adequate control or are not well tolerated due to side effects. There have been many randomized controlled trials of acupuncture on reduction of these symptoms. In this review, we will summarize the current evidence on the effect of acupuncture on the management of common symptoms experienced by patients with hematological malignancies and the current understanding of acupuncture's mechanism of action. The evidence is the strongest for reducing pain and nausea vomiting, less strong for symptoms such as peripheral neuropathy, fatigue, constipation, insomnia, night sweat, and pruritus.

Nonpharmacologic Treatment for Children with Functional Constipation: A Systematic Review and Meta-analysis.

Wegh CAM, Baaleman DF, Tabbers MM, Smidt H, Benninga MA · The Journal of pediatrics · 2022

To evaluate the effectiveness and safety of nonpharmacologic interventions for the treatment of childhood functional constipation. Randomized controlled trials (RCTs) evaluating nonpharmacologic treatments in children with functional constipation which reported at least 1 outcome of the core outcome set for children with functional constipation. We included 52 RCTs with 4668 children, aged between 2 weeks and 18 years, of whom 47% were females. Studied interventions included gut microbiome-directed interventions, other dietary interventions, oral supplements, pelvic floor-directed interventions, electrical stimulation, dry cupping, and massage therapy. An overall high risk of bias was found across the majority of studies. Meta-analyses for treatment success and/or defecation frequency, including 20 RCTs, showed abdominal electrical stimulation (n = 3), Cassia Fistula emulsion (n = 2), and a cow's milk exclusion diet (n = 2 in a subpopulation wi

Electro-Entero-Graphy (EEnG) for Non-invasive Diagnosis of Motility Disorders of the Bowel

n=34 · NCT04624334 · TERMINATED · TERMINATED

The current diagnostic process of colonic motility disorders often takes a long time and involves multiple invasive, painful and/or unnecessary diagnostic procedures. To improve this diagnostic process, the potential of Electro-Entero-Graphy (EEnG) is investigated. During the EEnG procedure, several surface electrodes are positioned (under ultrasound guidance) on the abdomen so that electrical activity originating in the colon can be measured. Measurements will be performed after a period of fasting (when the colon is 'silent') and just after a meal (when the colon is moving) in both participants suffering from colonic motility disorders and healthy controls. It is hypothesized that these measurements are an indication of colonic motility and can be used as a diagnostic tool for colonic motility disorders. It is also hypothesized that this EEnG procedure is not more burdensome than the Gold Standard procedures for diagnosing colonic motility disorders. This will be assessed using questionnaires.

A Phase III, Multicenter, Open Label, Extension Study to Evaluate the Long-Term Safety of Renzapride 4 mg Once Daily in Women With Constipation-Predominant Irritable Bowel Syndrome (IBS-C)

n=939 · NCT00607971 · TERMINATED · TERMINATED

The main purpose of this study is to evaluate the long-term safety and tolerability of renzapride at a dose of 4 mg taken once daily for 12 months in women with constipation-predominant irritable bowel syndrome (IBS-C).

Healthy Effects of an Innovative Probiotic Pasta

n=40 · NCT02236533 · COMPLETED · COMPLETED

The aim of the project was the evaluation of the antioxidant and anti-inflammatory effects of a whole grain pasta, enriched in barley β-glucans and fortified with strains of Bacillus coagulans, versus a control wheat pasta on healthy volunteers, using a parallel randomized controlled trial.

Cochrane Reviews on Constipation

Cochrane

Cochrane Library provides systematic reviews and meta-analyses on various interventions for constipation, offering high-quality evidence to inform clinical practice.

Chronic Constipation

TRIP Database

TRIP Database offers a federated search across multiple evidence-based resources to find research and clinical guidelines related to chronic constipation.

TRIP Database: Constipation

TRIP Database

TRIP Database is a clinical search engine designed to allow users to quickly find high-quality clinical evidence. Searching for 'constipation' yields results including clinical guidelines, systematic reviews, and primary research.