Systematic review and meta-analysis of the effect of probiotic supplementation on functional constipation in children

Background: To evaluate the effect of probiotic supplementation on functional constipation in children. Methods: We performed electronic searches in PubMed, Embase, and Cochrane Library without language restriction to identify relevant studies from the time of inception of these databases to March 2018. The relative risk or weighted mean difference was calculated to evaluate the treatment effect of probiotics using random-effects model. Results: We included 4 trials reporting data on 382 children with functional constipation. Overall, there were no significant differences in treatment success (P=.697), spontaneous bowel movements per week (P=.571), fecal soiling episodes per week (P=.642), straining at defecation (P=.408), use of lactulose (P=.238), use of laxatives (P=.190), fecal incontinence (P=.139), pain during defecation (P=.410), flatulence (P=.109), and adverse events (P=.979) between probiotics and placebo. Further, the use of probiotics was associated with lower frequency of glycerin enema use (weighted mean difference -2.40, P=.004) and abdominal pain (weighted mean difference -4.80, P<.001). Conclusion: The findings of this study suggested that the use of probiotics was associated with significant improvement in glycerin enema use and abdominal pain but did not affect the treatment success and other function indices.