Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Lactobacillus bulgaricus is a probiotic bacterium commonly used in the fermentation of yogurt and other dairy products. Its use for managing constipation in children is supported to a limited extent by scientific evidence. Several randomized controlled trials and systematic reviews have explored the benefits of probiotics (including L. bulgaricus, often as part of multi-strain formulations) in treating functional constipation in children. Some studies suggest that probiotics can improve stool frequency and consistency, likely by modulating the gut microbiota, enhancing intestinal motility, and producing short-chain fatty acids that stimulate colonic activity.

However, most clinical trials do not investigate L. bulgaricus alone; rather, they assess its effects as part of a combination of probiotic strains (such as in yogurt containing both L. bulgaricus and Streptococcus thermophilus). Results are mixed: some studies report modest improvements in constipation symptoms, while others find no significant effect compared to placebo. Moreover, authoritative guidelines—including those from the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN)—conclude that the evidence for probiotics in the treatment of pediatric constipation is currently insufficient to make a strong recommendation.

In summary, while there is some preliminary scientific rationale and weak clinical evidence supporting the use of L. bulgaricus-containing probiotics for childhood constipation, robust, strain-specific, and large-scale studies are lacking. Thus, the evidence is rated as low (2/5), and probiotics should not be relied upon as a primary therapy for pediatric constipation at this time.

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