Synergistic Adjuvant Therapy of Constipation with Probiotics and Prebiotics via Modulation of Gut Microbiota: Mechanisms, Evidence, and Prospects

Constipation is a prevalent functional gastrointestinal disorder. Conventional laxative therapies for constipation often entail risks of dependence and adverse effects. With the growing recognition of the crucial role of gut microbiota dysbiosis in its pathogenesis, gut microbiota modulation has emerged as a core strategy in novel therapies. Synbiotics, a combination of probiotics and prebiotics, demonstrates significant therapeutic potential through synergistic mechanisms: prebiotics selectively promote the colonization and proliferation of probiotics, and they synergistically optimize gut microbiota composition, enhance the production of short-chain fatty acids, and subsequently improve intestinal barrier function, regulate immune responses, and stimulate intestinal motility. Clinical evidence indicates that specific synbiotic formulations outperform single-component interventions in improving stool frequency, consistency, and overall symptoms. This advantage stems from the “nutrition-microbiota-metabolism” multiple-pathway synergistic effect. Future research should prioritize the development of personalized synbiotic regimens based on gut microbiota functional prediction, conduct large-scale clinical trials for functional validation, and explore their integration with novel delivery systems and functional food carriers, thereby advancing the development of constipation treatment toward the integration of precision microbiota-based intervention and enhancing its clinical utility and patients’ quality of life.