Health News Review

We think readers will be confused by how this story jumped from a research finding that there isn’t evidence to support probiotic use to an independent observer saying such use "is not unreasonable" and "is widely accepted." 

Our Review Summary

Even though an industry-supported trial showed that "a probiotic did not relieve constipation" more than a dairy product without a probiotic, the story seemed to go out of its way to find a future for the product in kids with this problem.  Even though it didn’t work in this trial, the researchers (some of whom were either employed by or supported by a probiotics manufacturer) say at the end that maybe they should now focus on probiotics in kids with a shorter history of constipation.  A cure in search of a problem?

We wish it had spent more time and space providing actual numbers – such as how many kids are severely affected, and how many actually improved in each arm of the trial and by how much. 

We thought there was some disease-mongering at play because not all kids’ constipation is the same, yet the story didn’t describe any spectrum of symptoms and impact.


Why This Matters

Constipation in children – as the researchers wrote – is a common and frustrating problem.  Readers with children dealing with constipation are interested in clear information about approaches to management that are supported by medical evidence.


Criteria

Not Satisfactory

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There was no mention of costs. How much would it cost to give kids such a probiotic product twice daily for three weeks as they did in the study?

Not Satisfactory

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story explained that the product "increased stool frequency, but not significantly."  Given the apparent existing controversy over the use of these products – at least as framed in the story – we think the story should have provided actual numbers. 

It became very confusing when the story jumped

  • from the researcher saying there is not enough evidence to support a general recommendation about the use of probiotics
  • to an Atlanta physician saying "it’s not unreasonable" to turn to probiotics for relief and "their use in clincal practice is widely accepted"
Not Satisfactory

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story didn’t discuss any harms that might occur from the use of probiotics.  Are there specific groups for which these products could be dangerous?  And if constipation is as serious as the story suggested, is there harm in first attempting self management with ineffectual products?

Satisfactory

Does the story seem to grasp the quality of the evidence?

Satisfactory

We’ll give the story a satisfactory score here – although the evidence is barely satisfactorily described.  It did an adequate job of explaining how the study was done.

Not Satisfactory

Does the story commit disease-mongering?

Not Satisfactory

We’re going to rule this one unsatisfactory.

The story explains that the study looked at kids "with constipation for at least two months with a defecation rate of less than three times per week."  Is that the definition of constipation?  If not, what is it? 

Instead, the story floats a scary statistic without giving a source – "despite intensive medical and behavioral therapy, 30% of patients who develop constipation before the age of 5 continue to have severe complaints." 

That sounds like 30% of ALL kids <5 who get constipation even though clearly there is a spectrum of problems from milder to more frequent and bothersome – something the story never clarifies.  That’s disease-mongering. Even the published research paper listed as a possible limitation that "this study was conducted in secondary and tertiary centers, which have attracted more severely constipated children."

The story explains that “constipation in children differs considerably from that in constipated adults with regard to its prevalence, onset, etiology, symptoms, treatment, and prognosis.”  But it doesn’t clarify what the differences are. 

Satisfactory

Does the story use independent sources and identify conflicts of interest?

Satisfactory

A comment from one independent source was included in this story.  The story indicated that two of the researchers involved in the study reported on were employees of Danone Research.  Although not mentioned in the story, a third researcher who was extensively quoted in this piece is listed at her host institution, as conducting work funded by Danone and using products supplied by Danone in the work.

Satisfactory

Does the story compare the new approach with existing alternatives?

Satisfactory

We’ll give the story the benefit of the doubt on this criterion. The story indicated that a regular diet supplemented with probiotics was not better for relief of constipation in children than supplementation with dairy products.

At the end of the piece, there was mention of treatment which consists of education, dietary advice, behavioral modification and then if these were unsuccessful, the use of laxatives. Because in this context ‘dietary advice’ often refers to fiber content and fluid consumption in the diet, it is not clear how probiotics compared to these other approaches.  

Not Satisfactory

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

 The story opened by informing readers that it was about "a specific bacterium, known as a probiotic" and although the story did indeed name the particular bacterium used in the study, it neglected to inform readers whether it was currently available to the public. And, since this was a European study, it raises even more questions in readers’ minds about how the findings relate to American products. 

Satisfactory

Does the story establish the true novelty of the approach?

Satisfactory

 The story provided information about other studies on constipation management that have been conducted with probiotic products in children and adults.

Not Applicable

Does the story appear to rely solely or largely on a news release?

Not Applicable

Because an independent expert was interviewed, it’s clear the story didn’t rely solely on a news release.

Total Score: 4 of 9 Satisfactory


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