Objective  To evaluate the clinical efficacy and influencing factors of Bifidobacterium, Lactobacillus and Enterococcus powder combined with polyethylene glycol on the  bowel preparation quality in patients with chronic constipation.

Methods  The clinical data of patients with chronic constipation who visited the Endoscopy Center of Putuo District People's Hospital of Zhoushan City from January 2021 to December 2023 were retrospectively analyzed. According to the patients' bowel preparation medication, they were divided into a probiotic group (Bifidobacterium, Lactobacillus and Enterococcus powder+polyethylene glycol) and a control group (polyethylene glycol). The Boston Bowel Preparation Score (BBPS) and adverse reactions were compared between the two groups, and univariate and multivariate Logistics regression were used to analyze the influencing factors of bowel preparation failure.

Results  A total of 267 patients with chronic constipation were included, with 142 in the probiotic group and 125 in the control group. The BBPS score (6.49±1.22 vs. 5.53±2.75) and the rate of bowel preparation compliance (76.06% vs. 58.40%) in the probiotic group were significantly higher than those in the control group (P﹤0.05). Multivariate logistic regression analysis showed that spontaneous bowel movements per week less than 1 [OR=0.41, 95%CI (0.26, 0.64)] and equal to 1 [OR=0.62, 95%CI (0.42, 0.90)], diabetes [OR=0.57, 95%CI (0.40, 0.81)], and dietary fiber intake <25 g [OR=0.49, 95%CI (0.34, 0.70)] were independent risk factors for bowel preparation failure, while the use of probiotics was a protective factor [OR=2.06, 95%CI (1.46, 2.90)]. There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion  In patients with chronic constipation, fewer spontaneous bowel movements per week, diabetes, and insufficient dietary fiber intake are independent risk factors for bowel preparation failure. The use of probiotics can significantly improve the cleanliness and compliance rate of bowel preparation without increasing the risk of adverse reactions.

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