ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Gastrointestinal and Hepatic Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1688544
Efficacy and safety of Live Combined Bacillus subtilis and Enterococcus faecium in patients with constipation: a meta-analysis of randomized controlled trials
Provisionally accepted
- Affiliated Hospital of Shandong Second Medical University, Weifang, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Live Combined Bacillus subtilis and Enterococcus faecium (LCBE) provides favorable clinical benefits in patients with constipation, while there lacks a comprehensive evaluation. This meta-analysis aimed to comprehensively evaluate the efficacy and safety of LCBE in patients with constipation. Methods: Randomized controlled trials assessing the efficacy or safety of LCBE in patients with constipation published before September 2025 were comprehensively searched in Wan Fang, China National Knowledge Infrastructure, China Science and Technology Journal Database, Web of Science, Cochrane Library, and PubMed. Efficacy and safety outcomes were collected. Results: Thirty-two studies were included, containing 1565 cases receiving LCBE plus control treatment (experimental group) and 1490 cases receiving control treatment alone (control group). Experimental group showed higher total effective rate [odds ratio (OR) (95% confidence interval (CI))=5.789 (4.598~7.288), P<0.001], Bristol stool scale score [standardized mean difference (SMD) (95% CI)=2.532 (1.274~3.790), P<0.001], defecation frequency per week [SMD (95% CI)=1.937 (1.252~2.623), P<0.001], and defecation rate within 24 hours [OR (95% CI)=2.545 (1.377~4.705), P=0.003] than control group. The defecation difficulty score tended to reduce in experimental group versus control group, although not reaching statistical significance [SMD (95% CI) =-1.924 (-3.947~0.099), P=0.062]. There was no difference in the total adverse reaction rate between groups [OR (95% CI) =0.703 (0.414~1.191), P=0.190]. Subgroup analyses suggested that LCBE was effective regardless of dosage form or treatment course. All studies were of moderate-to-high quality. Conclusion: LCBE exerts a favorable efficacy with good tolerance in patients with constipation. This meta-analysis provides supportive evidence for its clinical application in constipation.
Keywords: Constipation, Live Combined Bacillus subtilis and Enterococcus faecium, efficacy, Safety, Meta-analysis
Received: 19 Aug 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 Li, Liang, Li, Yang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoqian Zhang, zxq13853697396@163.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.