益生菌對成人功能性便秘之影響

功能性便秘 (functional constipation, FC) 屬於功能性胃腸疾病的一種，亦為慢性便秘的常見亞型，診斷上通常依據羅馬IV準則 (Rome IV criteria) 進行判定。主要特徵包括排便困難、排便頻率減少與排便不完全，這些症狀可能對患者的生活品質產生負面影響。過往文獻證實，益生菌可透過調節腸道菌群組成、改善腸道屏障功能與調控腸道環境等多種機制，進而改善慢性便秘患者的排便頻率和糞便稠度。因此，本研究欲探討益生菌改善功能性便秘成人之便秘症狀與生活品質之功效。本試驗招募49名年齡介於18-75歲，符合羅馬IV功能性便秘標準之男女性，並隨機分成3組：(1) 樣品A組 (n = 17)、(2) 樣品B組 (n = 17) 與 (3) 樣品C組 (n = 15)。受試者須每日早餐後30分鐘服用一顆益生菌膠囊，連續服用4週，後續停止服用再追蹤4週。於介入前後及追蹤後進行體位測量、血壓量測、飲食問卷填寫、便秘評分系統 (constipation scoring system, CSS) 與便秘患者生活品質評估問卷 (patient assessment of constipation quality of life questionnaire, PAC-QOL) 填寫，並於不同時間點進行血液常規分析與糞便酸鹼值、銨濃度與β-葡萄醣醛酸酶活性分析，同時受試者須每日紀錄排便日誌。試驗結果顯示與介入前相比，介入與追蹤後顯著提升排便頻率與糞便稠度。CSS問卷結果顯示，與介入前相比，排便頻率、排便困難度、排便失敗、疼痛及總分在介入後顯著改善，且追蹤後，排便頻率與疼痛亦較介入前顯著改善。在PAC-QOL問卷結果指出，受試者在介入後的心理社會不適、擔憂/顧慮、滿意度及整體得分顯著低於介入前，並在追蹤後，受試者的生理不適、擔憂/顧慮、滿意度及整體得分亦顯著低於介入前。在糞便分析中，銨濃度與β-葡萄醣醛酸酶的活性在介入與追蹤後顯著低於介入前，且追蹤後的銨濃度與β-葡萄醣醛酸酶的活性顯著低於介入後。綜合上述結果得知，本試驗之益生菌具有改善功能性便秘成人便秘症狀、生活品質以及腸道健康之潛在益處。

Functional constipation (FC) is classified as a functional gastrointestinal disorder and is also recognized as a common subtype of chronic constipation. Diagnosis of functional constipation is typically based on the Rome IV criteria and is characterized by straining during defecation, infrequent bowel movements, and a sensation of incomplete evacuation. All of the above symptoms may negatively impact the patient’s quality of life. Previous studies have demonstrated that probiotics may improve frequency of bowel movement and stool consistency in chronic constipation individuals through multiple mechanisms, including modulation of the gut microbiota composition, enhancement of intestinal barrier function, and regulation of the intestinal environment. Therefore, the aim of this study is to investigate the effects of probiotics on constipation symptoms and quality of life in FC adults. This trial enrolled 49 male and female participants aged 18–75 years who met the Rome IV criteria for functional constipation. Participants were randomly assigned to one of three groups: (1) Sample A group (n = 17), (2) Sample B group (n = 17), and (3) Sample C group (n = 15). Subjects were instructed to take one capsule daily 30 minutes after breakfast for four consecutive weeks, followed by a 4-week follow-up period without supplementation. Anthropometric measurements, blood pressure measurements, dietary questionnaire, constipation scoring system (CSS) survey, and patient assessment of constipation quality of life questionnaire (PAC-QOL) were conducted at baseline, intervention, and follow-up. Additionally, blood examinations, fecal pH, fecal ammonium concentration, and fecal β-glucuronidase activity were analyzed. Furthermore, participants were instructed to keep a daily bowel movement diary throughout the study. The results demonstrate that, compared to baseline, both stool frequency and stool consistency significantly improved after the intervention and follow-up. After the intervention, CSS scores demonstrated significant improvements in frequency of bowel movement, difficulty, failure of evacuation, pain, and total score compared to baseline. Moreover, frequency of bowel movement and pain remained significantly improved after the follow-up. PAC-QOL results showed significant improvements in psychosocial discomfort, worries/concerns, satisfaction, and total score after the intervention. Additionally, physical discomfort, worries/concerns, satisfaction, and total score were significantly improved after the follow-up compared to baseline. Fecal analysis revealed that ammonium concentration and β-glucuronidase activity were significantly lower after the intervention and follow-up compared to baseline. Additionally, the levels of these two parameters after the follow-up were significantly lower than after the intervention. In conclusion, these findings suggested that the probiotics intervention provided potential beneficial effects on constipation symptoms, quality of life, and gut health in FC adults.