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J Neurogastroenterol Motil. 2015 Jan 1;21(1):111-20. doi: 10.5056/jnm14048.

Change of Fecal Flora and Effectiveness of the Short-term VSL#3 Probiotic Treatment in Patients With Functional Constipation.

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Ewha Womans University School of Medicine, Seoul, Korea.
Wonkwang University School of Medicine, Iksan, Jeollabuk-do, Korea.
Keimyung University School of Medicine, Daegu, Korea.
Kosin University College of Medicine, Busan, Korea.
Dankook University College of Medicine, Cheonan, Chungcheongnam-do, Korea.
Soonchunhyang University College of Medicine, Seoul, Korea.
University of Ulsan College of Medicine, Seoul, Korea.
Konyang University College of Medicine, Daejon, Korea.



We investigated gut flora characteristics in patients with functional constipation (FC) and influences of short-term treatment with VSL#3 probiotic on flora and symptom improvement.


Thirty patients fulfilling Rome III criteria for FC and 30 controls were enrolled. Fecal samples were obtained before and after VSL#3 intake (one sachet twice daily for 2 weeks) and flora were examined by quantitative real-time polymerase chain reaction (qRT-PCR). Symptom changes were also investigated.


The fold differences in Bifidobacterium and Bacteroides species were significantly lower in feces from FC, compared to in controls (P = 0.030 and P = 0.021). After taking VSL#3, the fold differences in Lactobacillus, Bifidobacterium and Bacteroides species increased in controls (P = 0.022, P = 0.018, and P = 0.076), but not in FC. Mean Bristol scores and complete spontaneous bowel movements (CSBMs)/week increased significantly in FC after ingesting VSL#3 (both P < 0.001). Relief of subjective CSBM frequency, stool consistency and abdominal bloating were reported in 70%, 60%, and 47% of patients. After VSL#3 cessation, 44.4% of patients with symptom improvement experienced constipation recurrence mostly within one month.


Bifidobacterium and Bacteroides species might be quantitatively altered in FC. A short-term VSL#3 treatment can improve clinical symptoms of FC. Further studies are needed to investigate VSL#3's additional effects beyond altering gut flora to allevate constipation.


Constipation; Microbiome; Probiotics

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