Long-Term Intake of Probiotics Could Help to Improve Constipation, Increasing Positive Microbiome in Intestines


The effects of probiotic strains on both constipation and cognition among all individuals involved in a meta-analysis remains difficult to determine.

The long-term intake of some probiotics, including Lactobacillus and Bifidobacterium strains, could help to improve constipation while increasing the positive microbiota in the intestines, according to the results of a meta-analysis published in Heliyon.

Bifidobacterium, bacterial strain3d illustration. | Image Credit: picture-waterfall - stock.adobe.com

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Investigators added that it was difficult to determine the effects of the probiotic strains on both constipation and cognition among all individuals involved in the meta-analysis. They aimed to determine how probiotics affected older individuals’ cognition and frequency of constipation. In subgroup analyses, the effects of the probiotics were performed to determine the frequency of defecation for constipation, which was based on the strain and duration of intervention with the probiotic, and the fecal bacterial count, which was based on the type of bacteria and strain.

For the effects of cognition, the probiotics were measured on various cognition rating scales and by types of strains, including single of multiple. In the meta-analysis, investigators used Web of Science, EMBASE, and PubMed to identify studies to be included.

Investigators searched for studies conducted from 2000 to 2022, clinical trials and randomized controlled trials, studies in English, and for individuals who were aged 45 to 64 years, aged 65 years and older, and aged 80 years and older. They screened the articles and removed any duplications.

The revised Cochrane risk-of-bias tool was used to evaluate randomized trials and determine the quality of the studies. They were grouped as “high,” “low,” or “some concerns.”

There was a total of 13 studies included in the final meta-analysis, with 5 for constipation and 8 for cognitive function. For the 5 studies on constipation, the authors determined that the studies had low risk of bias, except for 1 study, which had some concerns. For the cognitive studies, 3 had concerns, whereas there was no high risk-of-bias for any of the studies included.

The findings indicated that there was a significant improvement in constipation after probiotic usage, but moderate heterogeneity was observed. The investigators also determined that there was some publication bias due to asymmetrical distribution in the dataset.

As for the subgroup analysis, there was no heterogeneity observed between the studies. Additionally, the results showed that the intervention did not influence the frequency of defecation in those who were constipated during the 3-week intervention period. However, the frequency did improve from 4 to 8 weeks and after 8 weeks.

Further, the single-strain probiotics effectively reduced constipation symptoms more than the multiple-strain supplementation. There were higher counts of fecal bacteria for those taking the single-strain supplements, with Lactobacillus counts being increased while Bifidobacterium counts did not significantly change, according to the study authors.

For cognition, the standardized mean difference of the cognition rating scales was not significantly influenced by the probiotic supplements, according to the investigators; additionally, there was high heterogeneity. The investigators also noted that the results showed that the probiotic supplementation did not improve the MMSE, RBANS, or other scores. However, single-strain probiotics showed more significant changes in cognition than the multiple-strain supplements, according to the study authors.

Investigators said that their study was limited, therefore, they said future studies should use the same type of single-strain supplementation and include individuals with similar constipation conditions to enhance the quality and reliability of the data. They said that it was difficult to investigate the differences of all the studies for both constipation and cognition.


Recharla N, Choi J, Puligundla P, Park SJ, Lee HJ. Impact of probiotics on cognition and constipation in the elderly: A meta-analysis. Heliyon. 2023;9(7):e18306. Published 2023 Jul 14. doi:10.1016/j.heliyon.2023.e18306

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