The importance of maintaining a healthy intestinal microbiota in the health of the host has been increasingly clarified. This microbiota may appear unbalanced in diseases such as colitis, diarrhea, irritable bowel syndrome and constipation. To rebalance the microbiota and improve the symptoms of constipation, it is recommended to intake prebiotics, probiotics and symbiotics, which works in the modulation of a healthy intestinal microbiota and favors the production of short-chain fatty acids that have a positive effect on intestinal transit. In addition, some studies indicate that there is a relation between the brain and the intestine that influences the behavior of individuals with intestinal dysbiosis. Thus, the reestablishment of the eubiosis in constipated patients through the functional compounds (prebiotics, probiotics and symbiotics) has been showing promising results regarding the modulation of constipation and improvement of the clinical picture. This review will emphasize the relation of prebiotics, probiotics and symbiotics in the modulation of intestinal constipation. New food sources of these compounds should be evaluated for their efficacy, dose and effect to establish a proper management.
Camilleri, M. and Bharucha, A.E. (2010) Behavioural and New Pharmacological Treatments for Constipation: Getting the Balance Right. Gut, 59, 1288-1296. http://dx.doi.org/10.1136/gut.2009.199653
Drossman, D.A. (2006) Rome III: The New Criteria. Chinese Journal of Digestive Diseases, 7, 181-185.
Gerritsen, J., Smidt, H., Rijkers, G.T. and De Vos, W.M. (2011) Intestinal Microbiota in Human Health and Disease: The Impact of Probiotics. Genes & Nutrition, 6, 209-240.
Waitzberg, D.L., Pereira, C.C., Logullo, L.C., Jacintho, M.T., Almeida, D., Silva, M.L.T. and Torrinhas, R.S. (2012) Microbiota Benefits after Inulin and Partially Hydrolized Guar Gum Supplementation—A Randomized Clinical Trial in Constipated Women. Nutricion Hospitalaria, 27, 123-129.
Ducrotté, P. (2010) Microbiota and Irritable Bowel Syndrome. Gastroentérologie Clinique et Biologique, 34, S52-S56. http://dx.doi.org/10.1016/S0399-8320(10)70021-X
Macfarlane, S., Macfarlane, G.T. and Cummings, J.H. (2006) Review Article: Prebiotics in the Gastrointestinal Tract. Alimentary Pharmacology & Therapeutics, 24, 701-714. http://dx.doi.org/10.1111/j.1365-2036.2006.03042.x
Brandt, K.G., Sampaio, M.C. and Miuki, C.J. (2006) Importancia da Microflora Intestinal. Pediatria, 28, 117-127.
Blaut, M. (2002) Relationship of Prebiotics and Food to Intestinal Microflora. European Journal of Nutrition, 41, i11-i16. http://dx.doi.org/10.1007/s00394-002-1102-7
Schiffrin, E.J. and Blum, S. (2002) Interactions between the Microbiota and Theintestinal Mucosa. European Journal of Clinical Nutrition, 56, 60-64. http://dx.doi.org/10.1038/sj.ejcn.1601489
Bouhnik, Y., Raskine, L., Simoneau, G., Vicaut, E., Neut, C., Flourie, B., Brouns, F. and Bornet, F.R. (2004) The Capacity of Nondigestible Carbohydrates to Stimulate fecal Bifidobacteria in Healthy Humans, a Double-Blind, Randomized, Placebo-Controlled, Parallel-Group, Dose-Response Relation Study. American Journal of Clinical Nutrition, 80, 1658-1664.
Manhart, N., Spittler, A., Bergmeister, H., Mittlbock, M. and Roth, E. (2003) Influence of Fructooligosaccharides on Peyer’s Patch Lymphocyte Numbers in Healthy and Endotoxemic Mice. Nutrition, 19, 657-660. http://dx.doi.org/10.1016/S0899-9007(03)00059-5
Hooper, L.V., Midtvedt, T. and Gordon, J.I. (2002) How Host-Microbial Interactions Shape the Nutrient Environment of the Mammalian Intestine. Annuals Reviews of Nutrition, 22, 283-307.
Montalto, M., Onofrio, F.D., Gallo, A., Cazzato, A. and Gasbarrini, G. (2009) Intestinal Microbiota and Its Functions. Digestive and Liver Disease Supplements, 3, 30-34. http://dx.doi.org/10.1016/S1594-5804(09)60016-4
Ley, R.E., Peterson, D.A. and Gordon, J.I. (2006) Ecological and Evolutionary Forces Shaping Microbial Diversity in the Human Intestine. Cell, 124, 837-848. http://dx.doi.org/10.1016/j.cell.2006.02.017
Hattori, M. and Taylor, T.D. (2009) The Human Intestinal Microbiome: A New Frontier of Human Biology. DNA Research, 16, 1-12. http://dx.doi.org/10.1093/dnares/dsn033
O’Hara, A.M. and Shanahan, F. (2006) The Gut Flora as a Forgotten Organ. EMBO Reports, 7, 688-693. http://dx.doi.org/10.1038/sj.embor.7400731
Magalhães, M.S., Salminen, S., Tommola, J., Collado, M.C., Ferreira, C.L., Anna, P. and Marchelli, R. (2011) Prebiotic. In: Magalhães, M.S., Salminen, S., Anna, P., Marchelli, R., Ferreira, C.L. and Tommola, J., Eds., Terminology, University of Turku, Turku, 50-65.
Macfarlane, G.T., Cummings, J.H. and Allison, C. (1986) Protein Degradation by Human Intestinal Bacteria. Journal of General Microbiology, 132, 1647-1656.
Hamer, H.M., Jonkers, D., Venema, K., Vanhoutvin, S., Troost, F.J. and Brummer, R.J. (2008) Review Article: The Role of Butyrate on Colonic Function. Alimentary Pharmacology & Therapeutics, 27, 104-119. http://dx.doi.org/10.1111/j.1365-2036.2007.03562.x
Cummings, J.H. and Englyst, H.N. (1987) Fermentation in the Human Large Intestine and the Available Substrates. American Journal of Clinical Nutrition, 45, 1243-1255.
Guarner, F. and Malagelada, J.R. (2003) Gut Flora in Health and Disease. The Lancet, 361, 512-519. http://dx.doi.org/10.1016/S0140-6736(03)12489-0
Gibson, G.R., Beatty, E.R., Wang, X. and Cummings, J.H. (1995) Selective Stimulation of Bifidobacteria in the Human Colon by Oligofructose and Inulin. Gastroenterology, 108, 975-982. http://dx.doi.org/10.1016/0016-5085(95)90192-2
Woodmansey, E.J. (2007) Intestinal Bacteria and Ageing. Journal of Applied Microbiology, 102, 1178-1186. http://dx.doi.org/10.1111/j.1365-2672.2007.03400.x
Quigley, E.M.M. (2011) The Enteric Microbiota in the Pathogenesis and Management of Constipation. Best Practice & Research Clinical Gastroenterology, 25, 119-126. http://dx.doi.org/10.1016/j.bpg.2011.01.003
Rhee, S.H., Pothoulakis, C. and Mayer, E.A. (2009) Principles and Clinical Implications of the Brain-Gut-Enteric Microbiota Axis. Nature Reviews Gastroenterology & Hepatology, 6, 306-314. http://dx.doi.org/10.1038/nrgastro.2009.35
Camara, R.J., Ziegler, R., Begré, S., Schoepfer, A.M. and Von Känel, R. (2009) The Role of Psychological Stress in Inflammatory Bowel Disease: Quality Assessment of Methods of 18 Prospective Studies and Suggestions for Future Research. Digestion, 80, 129-139. http://dx.doi.org/10.1159/000226087
Bonaz, B. and Sabate, J.M. (2009) Brain-Gut Axis Dysfunction. Gastroentérologie Clinique et Biologique, 33, S48-S58. http://dx.doi.org/10.1016/S0399-8320(09)71525-8
Denou, E., Bercik, P. and Collins, S.M. (2010) Perturbation of the Intestinal Microbiota Alters Behavior in Mice. Gastroenterology, 136, 776-787.
Husebye, E., Hellström, P.M., Sundler, F., Chen, J. and Midtvedt, T. (2001) Influence of Microbial Species on Small Intestinal Myoelectric Activity and Transit in Germ-Free Rats. American Journal of Physiology, Gastrointestinal and Liver Physiology, 280, G368-G380.
Mazmanian, S.K. Round, J.L. and Kasper, D.L. (2008) A Microbial Symbiosis Factor Prevents Intestinal Inflammatory Disease. Nature, 453, 620-625. http://dx.doi.org/10.1038/nature07008
Khalif, I.L., Quigley, E.M.M., Konovitch, E.A. and Maximova, I.D. (2005) Alterations in the Colonic Flora and Intestinal Permeability and Evidence of Immune Activation in Chronic Constipation. Digestive and Liver Disease, 37, 838-849. http://dx.doi.org/10.1016/j.dld.2005.06.008
Zoppi, G., Cinquetti, M., Luciano, A., Benini, A., Miner, A. and Bertazzoni, M.E. (1998) The Intestinal Ecosystem in Chronic Functional Constipation. Acta Paediatrica, 87, 836-841.
Chassard, C., Dapoigny, M., Scott, K.P., Crouzet, L., Del’homme, C., Marquet, P., Martin, J.C., Pickering, G., Ardid, D., Eschalier, A., Dubray, C., Flint, H.J. and Bernalier-Donadille, A. (2012) Functional Dysbiosis within the Gut Microbiota of Patients with Constipated-Irritable Bowel Syndrome. Alimentary Pharmacology & Therapeutics, 35, 828-838. http://dx.doi.org/10.1111/j.1365-2036.2012.05007.x
Nogueira, G.S., Zanin, C.R. and Gomes, J. (2010) Intervenção Cognitivo-Comportamental em Paciente com Constipação Intestinal: Relato de Caso. Revista Brasileira de Terapias Cognitivas, 6, 138-154.
Devroede, G., Girard, G., Bouchoucha, M., Roy, T., Black, R., Camerlain, M., et al. (1989) Idiopathic Constipation by Colonic Dysfunction. Relationship with Personality and Anxiety. Digestive Diseases and Sciences, 34, 1428-1433. http://dx.doi.org/10.1007/bf01538081
Collins, S.M. and Bercik, P. (2009) The Relationship between Intestinal Microbiota and the Central Nervous System in Normal Gastrointestinal Function and Disease. Gastroenterology, 136, 2003-2014. http://dx.doi.org/10.1053/j.gastro.2009.01.075
Hijova, E. and Chmelarova, A. (2007) Short Chain Fatty Acids and Colonic Health. Bratisl Lek Listy, 108, 354-358.
Irvine, E.J., Ferrazzi, S., Pare, P., Thompson, W.G. and Rance, L. (2002) Health-Related Quality of Life in Functional GI Disorders: Focus on Constipation and Resource Utilization. The American Journal of Gastroenterology, 97, 1986-1993. http://dx.doi.org/10.1111/j.1572-0241.2002.05843.x
Roberfroid, M. (2007) Prebiotics: The Concept Revisited. The Journal of Nutrition, 137, 830S-837S.
Laparra, J.M. and Sanz, Y. (2010) Interactions of Gut Microbiota with Functional Food Components and Nutraceuticals. Pharmacological Research, 61, 219-225. http://dx.doi.org/10.1016/j.phrs.2009.11.001
Morelli, L., Zonenschain, D., Callegari, M.L., Grossi, E., Maisano, F. and Fusillo, M. (2003) Assessment of a New Synbiotic Preparation in Healthy Volunteers: Survival, Persistence of Probiotic Strains and Its Effect on the Indigenous Flora. Nutrition Journal, 2, 11.
Almeida, L.B., Marinho, C.B., Souza, C.S. and Cheib, V.B.P. (2009) Disbiose Intestinal. Revista Brasileira de Nutrição Clinica, 24, 58-65.
Cummings, J.H. and Macfarlane, G.T. (2002) Gastrointestinal Effects of Prebiotics. British Journal of Nutrition, 87, S145-S151. http://dx.doi.org/10.1079/BJN/2002530
Kleessen, B., Svkura, B., Zunft, H.J. and Blaut, M. (1997) Effects of Inulin and Lactose on Fecal Microflora, Microbial Activity, and Bowel Habit in Elderly Constipated Persons. American Journal of Clinical Nutrition, 65, 1397-1402.
Yen, C.H., Kuo, Y.W., Tseng, Y.H., Lee, M.C. and Chen, H.L. (2011) Beneficial Effects of Fructo-Oligosaccharides Supplementation on Fecal Bifidobacteria and Index of Peroxidation Status in Constipated Nursing-Home Residents-A Placebo-Controlled, Diet-Controlled Trial. Nutrition, 27, 323-328. http://dx.doi.org/10.1016/j.nut.2010.02.009
Agrawal, A., Houghton, L.A., Morris, J., Reilly, B., Guyonnet, D., Feuillerat, N.G., Schlumberger, A., Jakob, S. and Whorwell, P.J. (2009) Clinical Trial: The Effects of a Fermented Milk Product Containing Bifidobacterium lactis DN-173 010 on Abdominal Distension and Gastrointestinal Transit in Irritable Bowel Syndrome with Constipation. Alimentary Pharmacology & Therapeutics, 29, 104-114. http://dx.doi.org/10.1111/j.1365-2036.2008.03853.x
Koebnick, C., Wagner, I., Leitzmann, P., Stern, U. and Zunft, F. (2003) Probiotic Beverage Containing Lactobacillus casei Shirota Improves Gastrointestinal Symptons in Patients with Chronic Constipation. Canadian Journal of Gastroenterology, 17, 655-659.
Ouwehand, A.C., Langström, H., Suomalainena, T. and Salminen, S. (2002) Effect of Probiotics on Constipation, Fecal Azoreductase Activity and Fecal Mucin Content in the Elderly. Annals Nutrition and Metabolism, 46, 159-162. http://dx.doi.org/10.1159/000063075
Amenta, M., Cascio, M.T., Di Fiore, P. and Venurini, I. (2006) Diet and Chronic Constipation. Benefits of Oral Supplementation with Symbiotic Zirfos (Bifidobacterium longumW11 + FOS Actilight). Acta Biomedica, 77, 157-162.
Waitzberg, D.L., Logullo, L.C., Bittencourt, A.F., Torrinhas, R.S., Shiromab, G.M., Paulino, N.P. and Teixeira-da-Silva, M.L. (2012) Effect of Synbiotic in Constipated Adult Women—A Randomized, Double-Blind, Placebo-Controlled Study of Clinical Response. Clinical Nutrition, 32, 27-33.
Ojansivu, I., Ferreira, C.L. and Salminen, S. (2011) Yacon, New Source of Prebiotic Oligosaccharides with a History of Safe Use. Trends of Food Science and Technology, 22, 40-46. http://dx.doi.org/10.1016/j.tifs.2010.11.005
Lachman, J., Fernandez, E.C. and Orsak, M. (2003) Yacon Smallanthus sonchifolia (Poepp. et Endl.) H. Robinson Chemical Composition and Use—A Review. Plant, Soil and Environment, 49, 283-290.
Genta, S., Cabrera, W., Habib, N., Pons, J., Carillo, I.M., Grau, A. and Sánchez, S. (2009) Yacon Syrup: Beneficial Effects on Obesity and Insulin Resistance in Humans. Clinical Nutrition, 28, 182-187. http://dx.doi.org/10.1016/j.clnu.2009.01.013
Rodrigues, V.C. (2011) Formulação, índice glicêmico e aplicação alimentar de um produto à base de yacon (Smallanthus sonchifolius). Tesis, 89p.
Valentova, K., Stejskal, D., Bartek, J., Dvoráckováa, S., Kren, V., Simánek, V. and Ulrichová, J. (2008) Maca [Lepidium meyenii] and Yacon [Smallanthus sonchifolius] in Combination with Silymarin as Food Supplements: In Vivo Safety Assessment. Food and Chemical Toxicology, 46, 1006-1013. http://dx.doi.org/10.1016/j.fct.2007.10.031
Rodrigues, F.C. (2011) Avaliação da farinha de yacon (Smallanthus sonchifolius) na modulação das propriedades biomecanicas e na retenção de minerais nos ossos de ratos wistar. Tesis, 180p.
Lobo, A., Colli, C., Alvares, E.P. and Filisetti, T.M. (2007) Effects of Fructans-Containing Yacon (Smallanthus sonchifolius Poepp & Endl.) Flour on Caecum Mucosal Morphometry, Calcium and Magnesium Balance, and Bone Calcium Retention in Growing Rats. British Journal of Nutrition, 97, 776-785. http://dx.doi.org/10.1017/S0007114507336805
Geyer, M., Manrique, I., Degen, L. and Beglinger, C. (2008) Effect of Yacon (Smallanthus sonchifolius) on Colonic Transit Time in Healthy Volunteers. Digestion, 78, 30-33. http://dx.doi.org/10.1159/000155214