Effect of Fermented Milk Containing Probiotics on Constipation Symptoms and Immune System in Subjects with Constipation

Abstract

Objective: To determine an effect of fermented milk containing probiotics (Bifidobacterium animalis sub. lactis) on constipation symptoms and immune system in healthy subjects with constipation.

Methods: This was a randomized triple blinded, cross-over controlled trial. Fifty healthy adult volunteers with constipation were included. A 10-week crossover study was conducted using Bifidobacterium yogurt and the regular yogurt. The subjects were divided into 2 groups and the study was divided into 4 periods i.e. pre-intake period (1 week), first intake period (3 weeks), rest period (3 weeks) and second intake period (3 weeks). The subjects were asked to keep a daily record of their defecation patterns of stool frequency, amount, shape, hardness, color, odor, straining during bowel movement, sensation of incomplete evacuation and blockage. Immune system changes were assessed using complete blood count, CD3+, CD8+, CD4+, CD19+, CD56+, and serum total IgA and IgG.

Results: Fifty constipated subjects aged 21-55 years were analyzed. Most of them were women. Baseline data on age, body mass index, dairy product, fiber or water intake, exercise, vital signs and blood tests between two groups were not significantly different. Carry-over effect and period effect were found to be significant in the present study. Therefore only the data from the first intake period were analyzed. Bifidobacterium yogurt intake increased frequency of defecation from 3 to 5.84 times/ week (p<0.001) and 3.20 to 4.56 times/week in the regular yogurt group (p=0.001) at 3 weeks. Probiotics yogurt increased frequency of defecation more than that in the regular yogurt 1.48 times/week (p=0.002). Stool quality was improved in all aspects in probiotics yogurt group (p=0.048). Only total score and sensation of blockage were improved in the regular yogurt group (p<0.001 and 0.048). Complete blood count and all CD markers had no clinically significant changes. Total IgA and IgG were decreased after 3 weeks of yogurt intake in both groups (p<0.001), but the changes had no clinical significance.

Conclusion: Stool frequency and quality of the constipated subjects were significantly improved after 3 weeks of Bifidobacte- rium yogurt and regular yogurt intake. Probiotics yogurt had more effects on stool frequency and quality than regular yogurt. No clinically important changes in immune system and no serious adverse events were observed in both groups.