The Efficacy of a Probiotic for Functional Constipation (FC)

A Randomised, Triple-blinded, Placebo-controlled, Parallel Group Pilot Study, to Assess the Effect of Probiotic on Functional Constipation and Gut Microbiology

Investigate the effect of a probiotic (live bacteria) in individuals with functional constipation.

This study aims to investigate the safety and efficacy of live bacteria on defecation parameters in individuals with Functional Constipation. The trial will be run in Germany and will recruit adult men and women meeting the ROME-IV criteria for functional constipation.

Inclusion Criteria:

1. Males (at least 30% of total number of subjects) and females ≥ 18 years and ≤65 years old

2. Body Mass Index (BMI) 18.5 - 30.0 kg/m2

3. Fulfilment of the Rome IV FC diagnostic criteria at V1 and V2

4. Self-reported average stool frequency of 3 or less bowel movements per week

5. Self-reported average stool consistency of type 1-4 on the Bristol Stool Form Scale

6. Cleveland Clinic Constipation Score > 8 at V1

7. Readiness not to use any treatment/supplementation for complaints related to constipation (e.g. prokinetics, laxatives, enemas) during the study; exception: glycerol suppository and if it provides no benefit, participants are allowed to take oral laxatives (see section 0)

8. Readiness and ability to comply with and perform the procedures requested by the protocol

9. If receiving proton pump inhibitors (PPI), anticipated to continue PPI therapy for the duration of the trial

10. Readiness not to have any change in habitual diet or exercise patterns over the study period

11. Women:

    • If sexually active, commitment to use contraception methods
    • negative pregnancy testing (beta human chorionic gonadotropin test in urine) at V1

12. Generally, in the opinion of investigator, healthy individuals (e.g. no heart failure, no malignancy) Participation is based upon written informed consent by the participant following written and oral information by the investigator regarding nature, purpose, consequences and possible risks of the clinical study.

Exclusion Criteria:

1. Clinically relevant (as per investigators judgement) self-reported chronic disease of the gastrointestinal tract (e.g. irritable bowel syndrome, Crohn's disease, ulcerative colitis, celiac disease, diverticulitis, malabsorption disorder), neurological, cardiovascular, endocrine/reproductive, renal, or other chronic diseases likely to affect gut motility
2. Prior abdominal surgery in the past 3 years (except for laparoscopic appendectomy and cholecystectomy and other minor laparoscopic surgeries, as per investigator judgement, that are allowed)
3. Ongoing regular use of products that (in the investigator's opinion) are known to cause constipation or change gastric motility (e.g. iron; opioids; sucralfate; 5-HT3 antagonists (e.g. ondansetron); antacids with magnesium, calcium, or aluminum; anticholinergic agents; calcium supplements; trycyclic antidepressants; systemic steroids)
4. Any subjects with use of PPI within the last 8 weeks prior to Visit 1 (exception: continuous use for ≥ 8 week before Visit 1 is allowed)
5. Post-menopausal women, defined as >12 months after the last menstrual bleeding and not using hormonal contraception
6. Women ≥ 50 years using hormonal contraception
7. ALARM features in the past 3 months prior to study (e.g. fever, unintentional weight loss ≥5 kg, blood in stool, vomiting) and moderate or severe anorectal problems (e.g. rectal bleeding, pelvic organ prolapse, anal fissures)
8. Previously diagnosed lactose intolerance, gluten intolerance, cow's milk allergy and/or soya-allergy
9. Known allergy or hypersensitivity to any ingredients of the investigational product
10. Consumption of biotic supplements (probiotics, prebiotics, synbiotics or post-biotics) within 2 weeks prior to Visit 1 and during the study
11. Regular consumption of fibre supplements and/or laxatives more than 1x a week
12. Use of laxatives within 48 hrs prior to Visit 1
13. Use of antibiotic within 4 weeks prior to Visit 1 and during the study
14. Ongoing alcohol, drug, or medication abuse
15. Participation in other clinical trials within 4 weeks prior to Visit 1 and during the study
16. Planning travel for >1 week during the study duration
17. Anticipated major changes in diet or exercise during the study
18. Pregnant or lactating or planned to become pregnant during the study period
19. Smoking > 5 cigarettes per week
20. An irregular diet, an abnormal sleep cycle, or other lifestyle abnormalities, as per investigator judgement
21. Individuals who, in the opinion of the investigator, are considered to be incompliant clinical attendees or unlikely for any reason to be able to complete the trial as required
22. Clinically relevant deviation of screening laboratory parameters at V1