Evidence map›Paper›PMID 38693449›Full record

SynthesisEuropean journal of nutrition2024

Network meta-analysis of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults.

Xinxin Deng, Cui Liang, Liying Zhou, Xue Shang, Xu Hui, Liangying Hou, Yongsheng Wang, Wendi Liu, Shanshan Liang, Liang Yao and 2 more

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European journal of nutrition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Review
  4. Review
  5. Review
  6. Article
  7. Review
  8. (Poly)phenol-gut microbiota interactions and their impact on human health.Current opinion in clinical nutrition and metabolic care · 2025
    Review
  9. Efficacy and safety of live combinedFrontiers in pharmacology · 2025
    Article
  10. Nutrients · 2024
    Article
  11. Synergistic defecation effects ofFrontiers in immunology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 2 countries.

Xinxin Deng *Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Cui Liang *Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Liying ZhouHealth Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Xue ShangSchool of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China.
Xu HuiEvidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Liangying HouEvidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Yongsheng WangHealth Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Wendi LiuHealth Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Shanshan LiangHealth Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.
Liang YaoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Kehu YangEvidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China. yangkh-ebm@lzu.edu.cn.
Xiuxia LiHealth Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China. lixiuxia@lzu.edu.cn.ORCID http://orcid.org/0000-0002-0210-9793
Lanzhou University · CNImpact · CASouthern University of Science and Technology · CN

Funding

Fundamental Research Funds for the Central Universities lzujbky-2021-ct06, lzujbky-2021-kb22
6 · The paper itself

Abstract

objectiveTo compare the outcomes associated with the use of probiotics, prebiotics, and synbiotics for the treatment of chronic constipation in adults.

methodsWe searched eight electronic databases from database inception to July 11, 2023, to identify randomized controlled trials (RCTs) that report efficacy and safety for the treatment of chronic constipation. The risk of bias in the included RCTs was evaluated according to the Cochrane tool, and the certainty of the evidence was assessed using the Confidence in Network Meta-Analysis framework. The analysis was conducted using R version 4.3.0.

resultsOut of the 37 RCTs, a total of 21 different types of interventions were reported, involving 3,903 patients. This NMA demonstrated that both prebiotics and synbiotics resulted in an increase in frequency of stool movements per week. Compared to placebo, lactulose (Mean difference [MD] = 3.39, 95% Confdence interval [CI] [1.13, 5.65], moderate certainty), mix2 (consisting of Lactulose and Bacillus coagulans) (MD = 3.63, 95% CI [1.37, 5.89], moderate certainty), mix6 (consisting of Lactulose and Bifidobacterium coagulans) (MD = 4.30, 95% CI [1.04, 7.54], low certainty), and mix7 (consisting of Lactulose, Bifidobacterium subtilis, and Enterococcus faecium) (MD = 4.58, 95% CI [1.35, 7.78], moderate certainty) exhibited a significant effect. Notably, mix7 demonstrated the highest probability of being the most effective intervention (94.8%). Furthermore, when compared to L. plantarum, four probiotics and two synbiotics showed significant advantages in the Patient Assessment of Constipation Symptoms (PAC-SYM) score. L. reuteri (MD = -13.74, 95% CI [-22.20, -4.66], very low certainty) exhibited a significant effect in improving the Patient Assessment of Constipation Quality of Life (PAC-QoL) score. In terms of safety, there were no statistically significant differences between the intervention and control groups in all adverse event analyses.

conclusionsModerate to very low evidence supports the use of lactulose and synbiotics to increase the number of weekly stool movements in patients, particularly highlighting the significant impact of synbiotics in increasing the number of weekly stool movements in patients with constipation. The use of L. paracasei showed improvements in PAC-SYM scores, while L. reuteri demonstrated enhancements in PAC-QoL scores.

Indexed as

ConstipationPrebioticsProbioticsSynbioticsAdultChronic DiseaseHumansRandomized Controlled Trials as TopicTreatment OutcomePrebioticsAdultsConstipationNetwork meta-analysisPrebioticProbioticSynbioticSystematic review

Identifiers

PMID38693449
OpenAlexW4396589298

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.