Reduction in breath methane and relief of constipation

 

Background: Detection of the gas methane (CH4) in exhaled breath is positively correlated to constipation, according to some research. Intestinal CH4 can slow intestinal transit time, and directly inhibit gut motility. Whether these alterations are a cause or a consequence of constipation is unknown.

This is an open trial, investigating the effect of L. reuteri Protectis DSM 17938 on the frequency of bowel movements and the level of methane in exhaled breath. The subjects were 20 constipated adults, all presenting with methane in their breath. Lactulose breath test was used at baseline and after 4 weeks of consumption of L. reuteri Protectis (2 tablets per day)

Positive detection of CH4 was defined as: production of > 5 ppm of CH4 at any time during four hours after oral ingestion of a 200-ml solution with 10 g of lactulose (= lactulose breath test).

 

 

Conclusion: Methane production in constipated adults can be reduced by daily ingestion of L. reuteri Protectis for four weeks. Reduced production of methane was associated with normalized number of weekly bowel movements. Ingestion of L. reuteri Protectis seems to modify the composition or the metabolism of methane producers of the gut microbiota.

L. reuteri Protectis reduced colic, constipation and regurgitation in infants

This multicentre, double-blind, placebo-controlled study investigated whether Lactobacillus reuteri DSM 17938 (L. reuteri Protectis) during the first three months could reduce the onset of colic, constipation and regurgitation in term newborns and thereby reduce the socio-economic impact of these conditions. 589 healthy infants were randomised to supplementation with either Lactobacillus reuteri Protectis drops (1×10^8 CFU) or placebo once daily for 90 days. 468 infants completed the study.

53% less of inconsolable crying of colic with L. reuteri Protectis compared to placebo at one month

53% less of inconsolable crying with L. reuteri Protectis compared to placebo at one month

After one month of intervention the infants in the Lactobacillus reuteri Protectis group cried less than half as long per day as the infants given placebo, 45 minutes compared to 96 minutes (p<0.01). The significant difference between the groups persisted to the end of the 3-month intervention.

The infants in the Lactobacillus reuteri Protectis group also had an improved gut motility, leading to significantly more daily evacuations and less regurgitation compared to the infants in the placebo group.

30% more daily evacuations with L. reuteri Protectis compared to placebo at one month

The infants in the Lactobacillus reuteri Protectis group also had an improved gut motility, leading to significantly more daily evacuations and less regurgitation compared to the infants in the placebo group. There were no adverse events reported.

37% fewer daily regurgitations with L. reuteri Protectis compared to placebo at three months

The study also evaluated the cost/benefit of the supplementation. The assessment model used did not take into account indirect costs such as those related to parental anxiety and stress. Calculating the direct costs only, the investigators concluded that the use of Lactobacillus reuteri Protectis saved each family 88 euro. In addition to this the community saved 104 euro per child.

The assessment model used did not take into account indirect costs such as those related to parental anxiety and stress. Calculating the direct costs only, the investigators concluded that the use of Lactobacillus reuteri Protectis saved each family 88 euro. In addition to this the community saved 104 euro per child.

€88 saved in direct costs for each family using Lactobacillus reuteri Protectis compared to placebo

Conclusions:
Prophylactic use of Lactobacillus reuteri Protectis during the first 3 months of life reduced the onset of functional gastrointestinal disorders and reduced private and public costs for the management of this condition.

Videos

Lactobacillus reuteri and gastrointestinal motility in preterm newborns

This is a double blind, placebo-controlled pilot study investigating the effects of daily probiotic supplementation on feeding tolerance and gastrointestinal motility in healthy, formula-fed preterm infants.

Thirty infants with a mean gestational age of 34 weeks and mean birth weight of 1,890 gram were enrolled. Ten infants were exclusively breast-fed, and 20 were randomly assigned to receive either 1×10^8 CFU (Colony Forming Units) of Lactobacillus reuteri ATCC 55730/day or placebo for 30 days, and a standard infant formula.

In each patient the gastric emptying rate was expressed as percent reduction in antral cross sectional area from time 0 to 120 minutes after the meal ingestion.

Fig. 1 In each patient the gastric emptying rate was expressed as percent reduction in antral cross sectional area from time 0 to 120 minutes after the meal ingestion.

Daily Lactobacillus reuteri supplementation to preterm formula-fed newborns improved tolerance to the formula. This was shown as a significant decrease in regurgitations and mean daily crying time, and an increased number of stools compared to those given placebo. Gastric emptying was also improved.At the end of the study period gastric emptying rate was significantly improved in formula-fed infants receiving Lactobacillus reuteri compared to the placebo group (P<0.001), as measured by ultrasonography.

Daily regurgitations were reduced to 2.1 vs. 4.2 (P<0.01) and daily bowel evacuations were increased to 3.7 vs. 2.1 (P<0.05), respectively. Daily crying time was significantly decreased to 32 minutes in the Lactobacillus reuteri group vs. 88 minutes/day in the placebo group (P<0.01). The breast-fed infants’ mean daily crying time was 66 minutes. Weight gain per day was similar in the three groups and there were no adverse events.

Conclusion: Daily Lactobacillus reuteri supplementation to preterm formula-fed newborns improved tolerance to the formula. This was shown as a significant decrease in regurgitations and mean daily crying time, and an increased number of stools compared to those given placebo. Gastric emptying was also improved.