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Effect of Lactobacillus casei Shirota on colonic transit time in patients with chronic constipation

Auswirkung von Lactobacillus casei Shirota auf die Transitzeit bei Patienten mit chronischer Obstipation

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coloproctology Aims and scope

Abstract

Background

Slow-transit constipation (STC) is caused by a motility disorder of the colon which leads to delayed transit (>72 h). The probiotic strain Lactobacillus casei Shirota (LcS) has been shown to improve constipation-related symptoms, such as stool frequency and consistency. A randomized double-blind placebo-controlled trial was performed to determine the effect of LcS on the colonic transit time in patients with STC.

Patients and methods

Colonic transit time of all consecutive outpatients with chronic constipation was determined by the Hinton test using radiopaque markers. Patients with a transit time longer than 72 h were included in the study. A total of 24 patients received either a dairy drink containing 6.5×109 colony forming units (cfu) of LcS or a placebo daily for 4 weeks. General gastrointestinal symptoms were evaluated weekly by a questionnaire and the measurement of colonic transit time was repeated after the intervention.

Results

The intake of LcS resulted in a significant acceleration of the total colonic transit time from 95.6 h to 76.5 h (p=0.05). This effect was most pronounced in the sigmoid and rectum transit time (p<0.007). In the placebo group no statistically significant change in the total colonic transit time was observed (before: 95.8 h, after: 87.1 h, p=0.282)

Conclusion

The daily intake of a probiotic drink containing LcS significantly reduced the colonic transit time in patients with STC.

Zusammenfassung

Hintergrund

Slow-transit constipation (STC) basiert auf einer Kolonmotilitätsstörung, welche zu einer verzögerten Transitzeit führt (>72 h). Es wurde bereits gezeigt, dass der probiotische Bakterienstamm Lactobacillus casei Shirota (LcS) Verstopfungssymptome wie Stuhlfrequenz und – konsistenz verbessern kann. Der Effekt von LcS auf die Transitzeit bei STC-Patienten wurde nun randomisiert doppelblind und Placebo-kontrolliert untersucht.

Patienten und Methoden

Bei ambulanten Patienten mit chronischer Verstopfung wurde konsekutiv die Kolontransitzeit durch den Hinton-Test mit röntgenfähigen Markern gemessen. Patienten mit einer Transitzeit über 72 Stunden wurden in die Studie eingeschlossen. Insgesamt 24 Patienten erhielten täglich ein Getränk mit LcS (6,5-mal 109 KBE) oder ein Placebo über einen Zeitraum von 4 Wochen. Danach wurde die Messung der Transitzeit wiederholt. Allgemeine gastrointestinale Symptome wurden durch einen wöchentlichen Fragebogen erfasst.

Ergebnisse

LcS führte zu einer signifikanten Beschleunigung der Kolontransitzeit von 95,6 auf 76,5 Stunden (p=0,05). Dieser Effekt war bei der sigmoiden und rektalen Transitzeit am ausgeprägtesten (p<0,007). Die Veränderung der Transitzeit von 95,8 auf 87,1 Stunden (p=0,282) in der Placebogruppe erreichte keine statistische Signifikanz.

Schlußfolgerung

Die tägliche Gabe eines probiotischen Getränks mit LcS reduzierte signifikant die Kolontransitzeit bei STC-Patienten.

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Interessenkonflikt

The corresponding author states the following: Diese Studie wurde von Yakult Honsha Co. Ltd, Japan gesponsort. Dr. Schaumburg steht in einem Beschäftigungsverhältnis der Yakult Deutschland GmbH. Prof. Dr. H. Krammer, Dr. von Seggern. Dr. F. Neumer ohne Interessenkonflikt.

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Authors and Affiliations

  1. Praxis für Gastroenterologie und Ernährungsmedizin am End- und Dickdarmzentrum Mannheim, Bismarckplatz 1, 68165, Mannheim, Deutschland

    H.-J. Krammer MD PhD, H. von Seggern & F. Neumer

  2. Yakult Deutschland GmbH, Neuss, Deutschland

    J. Schaumburg

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  1. H.-J. Krammer MD PhD
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  2. H. von Seggern
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  3. J. Schaumburg
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  4. F. Neumer
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Corresponding author

Correspondence to H.-J. Krammer MD PhD.

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Krammer, HJ., von Seggern, H., Schaumburg, J. et al. Effect of Lactobacillus casei Shirota on colonic transit time in patients with chronic constipation. coloproctology 33, 109–113 (2011). https://doi.org/10.1007/s00053-011-0177-0

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  • DOI: https://doi.org/10.1007/s00053-011-0177-0

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