Background
nine-strain, constipation
Recent advances in microbiome tools (e.g., culturing, bioinformatics) have enabled a deeper understanding of microbial ecology and the gut microbiome’s role in human health. Gastrointestinal microbes exert functional influence on the host through a range of metabolic and immunological mechanisms, and the host shapes resident microbial communities through diet, nutrition, lifestyle, and medication.Gut microbiota are suggested to influence bowel movement frequency through multiple mechanisms. These include ligand-receptor type interactions with the competitive exclusion of pathogens, generation of antibacterial substances, setting an anti-inflammatory tone to the gut environment, signaling effects that influence the enteric nervous system, and breakdown of fiber to generate short-chain fatty acids that improve gut function.A number of pilot studies have been conducted to identify if microbial therapies can improve the quantity and quality of weekly bowel movements (WBMs). These have included supplementation of live bacteria (i.e., candidate probiotics), ingredients to support the growth of beneficial organisms (i.e., prebiotics), or a combination of the two (i.e., synbiotics). In children, an intake of inulin-type fructans has been associated with softer stool consistencyFor specific strains, there have been statistically significant, beneficial outcomes in human trials.Consequently, there is a need to test in placebo-controlled trials the efficacy of microbial therapies in reducing pediatric constipation and its associated symptoms. Here, we do so in a pilot study to determine the impact of a nine-strain (eight species) synbiotic (a prebiotic and defined microbial consortium) formulation (with the prebiotic comprising mixed-chain length oligosaccharides) on ameliorating constipation.