**4.8 Effect of probiotics in constipation**

Constipation is quite a common condition that can be acute or chronic. Constipation causes a general feeling of abdominal discomfort. To pass the stool straining may put pressure on the tissues and structures of the anal area with adverse consequences such as hemorrhoids (piles). Other diseases associated with constipation are irritable bowel syndrome and cancer of the large bowel. Several studies have been conducted using *Lactobacillus rhamnosus, Lactobacillus casei, Bifidobacterium animalis,* and probiotic *E. coli.* [61, 62]. Prebiotics also may be effective against constipation as FOS, GOS, and lactulose have mild laxative effects [63]. These laxative effects can be due to osmosis as prebiotics are soluble fibers. Prebiotics also boost bifidobacteria and lactobacilli, and these probiotic bacteria accelerate the transit of large bowel content. However, meta-analyses also indicate that groups of probiotics and synbiotics have more efficiency than individual probiotics [64].
