World J Gastroenterol. 2025 Oct 28;31(40):112637. doi: 10.3748/wjg.v31.i40.112637.
ABSTRACT
BACKGROUND: Gut microbiota dysbiosis plays a central role in the pathogenesis of functional constipation (FC), but clinical treatment has shown uneven efficacy through methods of regulating intestinal flora. Most existing studies have concentrated on overall case-control comparisons, with limited stratification by age or constipation subtype. Knowledge of how these factors shape gut microbiota composition remains inadequate, constraining the development of effective personalized microbiota-based interventions.
AIM: To characterize gut microbiota profiles by age and constipation subtype and identify factors associated with microbial composition in FC.
METHODS: Ninety-two patients with FC completed questionnaires and underwent anorectal manometry and gastrointestinal transit tests; stool samples were collected for 16S rRNA gene sequencing. Stool samples alone were collected from 34 healthy controls. Patients with FC were categorized into age groups (young, middle-aged, and older) and classified into normal-transit constipation, slow-transit constipation (STC), defecatory disorder (DD), and mixed constipation subtypes. Gut microbial compositions across age groups and constipation subtypes were compared, and their correlations with clinical parameters were investigated.
RESULTS: The young group demonstrated significantly higher anal resting and squeeze pressures than the middle-aged and the older groups. Microbial richness and diversity were substantially lower in the older group than in middle-aged and young groups. Gut microbiota in the young group was predominantly enriched in taxa increasing sphincter tone and inhibiting intestinal peristalsis; the older group featured abundances of short-chain fatty acid-producing, beneficial taxa. The middle-aged group showed an enrichment of pro-inflammatory and pathogenic bacteria. Microbial richness and diversity were higher in STC than in the DD group. Moreover, STC group was enriched in taxa associated with slower peristalsis; DD group showed enrichment of motility-promoting taxa.
CONCLUSION: Significant differences in microbial composition and function were observed across age groups and constipation subtypes in FC, suggesting underlying pathophysiological heterogeneity and providing a basis for precision diagnosis and treatment.
PMID:41180988 | PMC:PMC12576558 | DOI:10.3748/wjg.v31.i40.112637
