Usefulness of Bifidobacterium longum BB536 in Elderly Individuals With Chronic Constipation: A Randomized Controlled Trial

Abstract

Introduction: Few reports exist regarding the therapeutic effects of probiotics on chronic constipation in elderly individuals. This study evaluated the effects of Bifidobacterium longum BB536 in elderly individuals with chronic constipation.

Methods: This was a randomized, double-blind placebo-controlled, parallel-group superiority trial in Japan (UMIN 000033031). Eighty older adults diagnosed with chronic constipation were randomly assigned (1:1) to receive either probiotics ( B. longum BB536, 5 × 10 10 colony-forming unit, n = 39) or placebo (n = 41) once daily for up to 4 weeks. The severity of constipation was evaluated using the Constipation Scoring System. The primary end point was the difference in the changes from baseline in the constipation scoring system total score between the 2 groups at week 4.

Results: A total of 79 patients (mean age of 77.9 years), including 38 patients in the BB536 group and 41 in the placebo group, completed the study. The primary end point was not significant ( P = 0.074), although there was significant improvement ( P < 0.01) in the BB536 group from baseline to week 4, but there were no significant changes in the placebo group. There was a significant difference and a tendency toward a difference in the changes from baseline on the stool frequency ( P = 0.008) and failure of evacuation ( P = 0.051) subscales, respectively, at week 4 between the 2 groups. Few adverse events related to the probiotics were observed.

Discussion: The primary end points were not significant. However, probiotic supplementation significantly improved bowel movements. These results suggest that B. longum BB536 supplementation is safe and partially effective for improving chronic constipation in elderly individuals.

Graphical abstract

Figure 1.

Trial profile.

Figure 2.

Effect of Bifidobacterium longum BB536 administration on the clinical symptoms in elderly individuals with chronic constipation. (a) Changes in the Constipation Scoring System (CSS) scores from baseline. (b) Changes in the frequency scale for the symptoms of gastrointestinal reflux disease scores (gastrointestinal reflux disease [GERD]) from baseline. *P < 0.05, **P < 0.01, significant difference from baseline (Wilcoxon signed-rank test); †P < 0.05, significant difference compared to the placebo group (Wilcoxon rank-sum test).

Figure 3.

Effect of Bifidobacterium longum BB536 administration on the gut microbiota composition. (a) Bray–Curtis distance principal coordinate analysis (PCoA). (b) Differences in the genera before and after administration in each group. *P < 0.05 (Wilcoxon signed-rank test).