On Friday I was messaged by a reader that have had extreme constipation. I have not done a post on constipation yet, but I do have a case report from another reader that had severe constant constipation, no longer has it (nor needing to take any drugs for it)

“Dec 24, 2015 started with:

• Prescript Assist
• L. Casei  – 4 capsules per day or (Yakult etc)
• 15 mg gum arabic

January 9, 2016 – constipation effectively gone.

Remember oats, fruits, vegetables and whole grains”

Probiotics

Moving on to PubMed, remember some probiotics can increase constipation — it is not just probiotics, but the right ones!

• Therapeutic effects of Lactobacillus casei Qian treatment in activated carbon-induced constipated mice[2015].“These results suggested that lactic acid bacteria prevent constipation in mice, among which LC-Qian was the most effective.”
• Effect of fermented milk containing Lactobacillus casei strain Shirota on constipation-related symptoms and haemorrhoids in women during puerperium. [2015] “Results of this study indicate that continuous consumption of fermented milk containing LcS might alleviate constipation-related symptoms, provide satisfactory bowel habit..”
• The effect of Lactobacillus reuteri supplementation in adults with chronic functional constipation: a randomized, double-blind, placebo-controlled trial. [2014] “L. reuteri is more effective than the placebo in improving bowel movement frequency in adult patients with functional constipation as previously demonstrated in children, even if it seems to have no effect on stool consistency.” [Sources of L. Reuteri]
• Systematic review of randomised controlled trials: probiotics for functional constipation. [2010] “In adults, data suggests a favourable effect of treatment with Bifidobacterium lactis DN-173 010, Lactobacillus casei Shirota, and Escherichia coli Nissle 1917 on defecation frequency and stool consistency. In children, L. casei rhamnosus Lcr35, but not L. rhamnosus GG, showed a beneficial effect.”
• “Probiotic treatment of irritable bowel syndrome in children.[2010]” reports success with constipation in IBS using Symbioflor-2.

There are no studies on Prescript Assist and constipation. Prescript Assist is well studied for IBS and found effective.

Herbs

• Gum Arabic in treatment of functional constipation in children in Sudan [2013]

• Constipation and Botanical Medicines: An Overview [2015]. “the most common botanical laxatives such as senna, cascara, frangula, aloe, and rhubarb and their use in the treatment of constipation.” rhubarb is also an effective antimicrobial especially against S.Aureus.
  • “[Antimicrobial activity and chemical differences between the two chemotypes of rhubarbs].” It suggested that the antimicrobial activity of rhubarb might be related to some unknown components which were of same accumulating pattern of rhein. The findings in present study provided some experimental evidence on categorizing rhubarb into two chemotypes through the difference of antimicrobial activity on S. aureus”

Unusual Finding

In reviewing the literature for this post, I came across this — an article that found that rhubarb effectiveness can be increased up to 2000 fold by taking with a multidrug pump inhibitor. Bacteria has “pump” that pushes out toxins — which can often be the antibiotics trying to kill it. By slowing or stopping these pumps — the bacteria succumbs to the antibiotic (be it prescription or herbal)

• Multidrug pump inhibitors uncover remarkable activity of plant antimicrobials.[2002] “It is possible that the apparent ineffectiveness of plant antimicrobials is largely due to the permeability barrier. ….The results show that the activities of the majority of plant antimicrobials were considerably greater against the gram-positive bacteria Staphylococcus aureus and Bacillus megaterium and that disabling of the MDRs in gram-negative species leads to a striking increase in antimicrobial activity. Thus, the activity of rhein, the principal antimicrobial from rhubarb, was potentiated 100- to 2,000-fold (depending on the bacterial species) by disabling the MDRs.”
  [Full Text]
  • More on multidrug pump inhibitors: Bacterial multidrug efflux pumps: Mechanisms, physiology and pharmacological exploitations [2014] “Another group of EPIs is called the quinoline derivatives, because of their structural similarity with quinolones [143].”  – interesting because Jadin’s protocol includes the concurrent use of quinolones with other antibiotics.
  • “In Gram-positive bacteria, EPIs against the NorA system in S. aureus has been intensively studied. A large number of both synthetic and natural compounds have been found to be EPIs against S. aureus NorA, especially those of natural origins such as genistein isolated from Lupinus argenteus, spinosan A isolated from Dalea spinosa and Tiliroside isolated from Herissantia tiubae”  Genistein is available as a supplement.

Bottom Line

The successful elimination of constipation reported by the reader is supported by PubMed articles. There are additional probiotics reported with good results in the literature. Symbioflor-2 and Mutaflor are both cited.

Rhubarb and genistein taken together is another approach, one that I would suggest be tried before (and NOT concurrent with) probiotics. There is a significant herx risk from this.

— as always consult with your knowledgeable medical professional before making any changes in supplements.