{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:43:36Z","timestamp":1793105016066,"version":"4.5.0"},"reference-count":72,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The purpose of this study is to compare the relative effectiveness and safety of non-pharmacological interventions for the treatment of functional constipation (FC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched Pubmed, Embase, Cochrane, and Web of Science databases for randomized controlled trials published from 2010 to November 2024. The quality of the included studies was evaluated using the Cochrane bias risk tool and Review Manager 5.4, and the evidence was graded using GRADEPro. A network meta-analysis (NMA) was conducted using R Studio, and the surface under the cumulative ranking curve (SUCRA) was used to rank the included drugs for each outcome measure to compare the clinical efficacy of different treatment methods for chronic functional constipation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 29 RCT studies were included, with a total of 4389 patients with functional constipation who were randomly assigned to receive placebo or one of the nine different non-pharmacological treatment methods. The assessment of bias risk showed that the bias risk of most included studies was low. The results showed that the first-ranked treatment method for clinical efficacy was acupuncture; the first-ranked treatment method for changes in spontaneous bowel movement (SBM) and complete spontaneous bowel movement (CSBM) was fecal microbiota transplantation (FMT); the first-ranked treatment method for changes in the Bristol Stool Form Scale (BSFS) score was FMT; the first-ranked treatment method for changes in the Patient Assessment of Constipation Quality of Life (PAC-QOL) score after treatment was the Vibration capsule; the first-ranked treatment method for changes in the Patient Assessment of Constipation Symptoms (PAC-SYM) score after treatment was percutaneous electrical stimulation; and the treatment method with the lowest incidence of adverse reactions was probiotics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the SUCRA values and NMA results, we found that FMT showed better effects and higher safety on BSFS scores, SBM, and CSBM. In addition, acupuncture showed a good clinical efficacy. We hypothesize that the combination of FMT and acupuncture may be an effective and safe treatment option for functional constipation, but further high-quality clinical studies are needed to confirm this.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:uri>, identifier CRD42024625747.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2025.1565801","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T08:47:53Z","timestamp":1748508473000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical efficacy of non-pharmacological treatment of functional constipation: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Shufa","family":"Tan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengtao","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanyue","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunyi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhong","family":"Bian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1126\/science.abi6087","article-title":"Signaling inflammation across the gut-brain axis","volume":"374","author":"Agirman","year":"2021","journal-title":"Science."},{"key":"B2","doi-asserted-by":"publisher","first-page":"617","DOI":"10.3920\/BM2018.0163","article-title":"The effect of a probiotic blend on gastrointestinal symptoms in constipated patients: a double blind, randomised, placebo controlled 2-week trial","volume":"10","author":"Airaksinen","year":"2019","journal-title":"Benef Microbes."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1097\/DCR.0000000000003430","article-title":"The American society of colon and rectal surgeons clinical practice guidelines for the evaluation and management of chronic constipation","volume":"67","author":"Alavi","year":"2024","journal-title":"Dis. Colon Rectum."},{"key":"B4","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1186\/s12877-023-03881-7","article-title":"Effectiveness of auricular acupressure on constipation and related quality of life among the older people in the residential care home: a randomized clinical trial","volume":"23","author":"Aminizadeh","year":"2023","journal-title":"BMC Geriatr."},{"key":"B5","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1080\/17474124.2020.1708718","article-title":"An approach to the diagnosis and management of Rome IV functional disorders of chronic constipation","volume":"14","author":"Aziz","year":"2020","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1016\/S2468-1253(21)00111-4","article-title":"Global prevalence of functional constipation according to the Rome criteria: a systematic review and meta-analysis","volume":"6","author":"Barberio","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/nu14194146","article-title":"Two gold kiwifruit daily for effective treatment of constipation in adults-A randomized clinical trial","volume":"14","author":"Bayer","year":"2022","journal-title":"Nutrients."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1053\/j.gastro.2019.12.034","article-title":"Mechanisms, evaluation, and management of chronic constipation","volume":"158","author":"Bharucha","year":"2020","journal-title":"Gastroenterology."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2019.102219","article-title":"Effect of abdominal massage on constipation and quality of life in older adults: A randomized controlled trial","volume":"47","author":"Bilgili","year":"2019","journal-title":"Complement Ther. Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s12603-022-1747-2","article-title":"Effectiveness of partially hydrolyzed guar gum in reducing constipation in long term care facility residents: A randomized single-blinded placebo-controlled trial","volume":"26","author":"Chan","year":"2022","journal-title":"J. Nutr. Health Aging."},{"key":"B11","first-page":"678","article-title":"Highlights from the joint AGA\/ACG guideline on pharmacologic management of chronic idiopathic constipation","volume":"20","author":"Chang","year":"2024","journal-title":"Gastroenterol. Hepatol (N Y)."},{"key":"B12","doi-asserted-by":"publisher","first-page":"768","DOI":"10.3760\/cma.j.cn311367-20200706-00432","article-title":"Efficacy and complications of fecal microbiota transplantation: a 5-year follow-up analysis of 3 932 cases","volume":"40","author":"Chen","year":"2020","journal-title":"Chin J. Gastroenterol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1111\/apt.15073","article-title":"Randomised clinical trial: Bifidobacterium lactis NCC2818 probiotic vs placebo, and impact on gut transit time, symptoms, and gut microbiology in chronic constipation","volume":"49","author":"Dimidi","year":"2019","journal-title":"Aliment Pharmacol. Ther."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzac058","article-title":"Abdominal massage in functional chronic constipation: A randomized placebo-controlled trial","volume":"102","author":"Do\u011fan","year":"2022","journal-title":"Phys. Ther."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1016\/j.cgh.2013.12.005","article-title":"Efficacy and safety of a magnesium sulfate-rich natural mineral water for patients with functional constipation","volume":"12","author":"Dupont","year":"2014","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1017\/S0007114522003853","article-title":"Functional constipation and the effect of prebiotics on the gut microbiota: a review","volume":"130","author":"Erhardt","year":"2023","journal-title":"Br. J. Nutr."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.956528","article-title":"Abnormal bile acid metabolism is an important feature of gut microbiota and fecal metabolites in patients with slow transit constipation","volume":"12","author":"Fan","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"649","DOI":"10.3760\/cma.J.c.n311367-20240930-00373","article-title":"Chinese standard for clinical diagnosis and treatment of chronic constipation","volume":"44","year":"2024","journal-title":"digest magazine"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2288","DOI":"10.14309\/ajg.0000000000002958","article-title":"Effects of retrograde colonic enema-based fecal microbiota transplantation in the treatment of childhood constipation: A randomized, double-blind, controlled trial","volume":"119","author":"Gu","year":"2024","journal-title":"Am. J. Gastroenterol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1080\/19490976.2017.1412908","article-title":"Effects of 28-day Bifidobacterium animalis subsp. lactis HN019 supplementation on colonic transit time and gastrointestinal symptoms in adults with functional constipation: A double-blind, randomized, placebo-controlled, and dose-ranging trial","volume":"9","author":"Ibarra","year":"2018","journal-title":"Gut Microbes."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/nu11020439","article-title":"Efficacy of polydextrose supplementation on colonic transit time, bowel movements, and gastrointestinal symptoms in adults: A double-blind, randomized, placebo-controlled trial","volume":"11","author":"Ibarra","year":"2019","journal-title":"Nutrients."},{"key":"B22","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.freeradbiomed.2016.12.015","article-title":"Enterosalivary nitrate metabolism and the microbiome: Intersection\u00a0of microbial metabolism, nitric oxide and diet in cardiac and pulmonary\u00a0vascular health","volume":"105","author":"Koch","year":"2017","journal-title":"Free Radic. Biol. Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"8043841","DOI":"10.1155\/2022\/8043841","article-title":"Electroacupuncture Improves Intestinal Motility through Exosomal miR-34c-5p Targeting SCF\/c-Kit Signaling Pathway in Slow Transit Constipation Model Rats","volume":"2022","author":"Kuang","year":"2022","journal-title":"Evid Based Complement Alternat Med"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2023.2197837","article-title":"Effects of dietary fibers or probiotics on functional constipation symptoms and roles of gut microbiota: a double-blinded randomized placebo trial","volume":"15","author":"Lai","year":"2023","journal-title":"Gut Microbes."},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1186\/s12906-018-2243-4","article-title":"Efficacy and safety of acupuncture for functional constipation: a randomised, sham-controlled pilot trial","volume":"18","author":"Lee","year":"2018","journal-title":"BMC Complement Altern. Med."},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.1038945","article-title":"The autonomic nervous system: A potential link to the efficacy of acupuncture","volume":"16","author":"Li","year":"2022","journal-title":"Front. Neurosci."},{"key":"B27","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/j.wjam.2020.07.014","article-title":"Research status and development trend of acupuncture indications","volume":"30","author":"Liu","year":"2020","journal-title":"World J. Acupuncture-Moxibustion"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/7931730","article-title":"Current applications of fecal microbiota transplantation in functional constipation","volume":"2022","author":"Liu","year":"2022","journal-title":"Evid Based Complement Alternat Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"761","DOI":"10.7326\/M15-3118","article-title":"Acupuncture for chronic severe functional constipation: A randomized trial","volume":"165","author":"Liu","year":"2016","journal-title":"Ann. Intern Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.molmet.2018.03.004","article-title":"Enterochromaffin 5-HT cells - A major target for GLP-1 and\u00a0gut microbial metabolites","volume":"11","author":"Lund","year":"2018","journal-title":"Mol. Metab."},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2023.106755","article-title":"Effect of the probiotic strain, Lactiplantibacillus plantarum P9, on chronic constipation: A randomized, double-blind, placebo-controlled study","volume":"191","author":"Ma","year":"2023","journal-title":"Pharmacol. Res."},{"key":"B32","doi-asserted-by":"publisher","first-page":"3570","DOI":"10.1111\/1750-3841.15392","article-title":"Intake of okara soup for 2 weeks for breakfast improved defecation habits in young Japanese women with self-reported constipation: A randomized, double-blind, placebo-controlled, intervention study","volume":"85","author":"Maeta","year":"2020","journal-title":"J. Food Sci."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1111\/jgh.12168","article-title":"Effects of a probiotic fermented milk on functional constipation: a randomized, double-blind, placebo-controlled study","volume":"28","author":"Mazlyn","year":"2013","journal-title":"J. Gastroenterol. Hepatol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1111\/apt.15642","article-title":"Randomised clinical trial: transabdominal interferential electrical stimulation vs sham stimulation in women with functional constipation","volume":"51","author":"Moore","year":"2020","journal-title":"Aliment Pharmacol. Ther."},{"key":"B35","doi-asserted-by":"publisher","first-page":"n160","DOI":"10.1136\/bmj.n160","article-title":"PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B36","doi-asserted-by":"publisher","first-page":"155","DOI":"10.23876\/j.krcp.24.174","article-title":"Constipation and risk of death and cardiovascular events in patients on hemodialysis","volume":"44","author":"Park","year":"2025","journal-title":"Kidney Res. Clin. Pract."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.14309\/ajg.0000000000001222","article-title":"Efficacy and safety of over-the-counter therapies for chronic constipation: an updated systematic review","volume":"116","author":"Rao","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13890","article-title":"Effects of the vibrating capsule on colonic circadian rhythm and bowel symptoms in chronic idiopathic constipation","volume":"32","author":"Rao","year":"2020","journal-title":"Neurogastroenterol Motil."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1053\/j.gastro.2023.02.013","article-title":"Randomized placebo-controlled phase 3 trial of vibrating capsule for chronic constipation","volume":"164","author":"Rao","year":"2023","journal-title":"Gastroenterology."},{"key":"B40","doi-asserted-by":"publisher","first-page":"51","DOI":"10.3920\/BM2017.0049","article-title":"Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation","volume":"9","author":"Riezzo","year":"2018","journal-title":"Benef Microbes."},{"key":"B41","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1111\/nmo","article-title":"Safety and efficacy of the vibrating capsule, an innovative non-pharmacological treatment modality for chronic constipation","volume":"27","author":"Ron","year":"2015","journal-title":"Neurogastroenterol Motil."},{"key":"B42","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1163\/18762891-bja00038","article-title":"Bifidobacterium animalis subsp. lactis BLa80 regulates the intestinal habit in adults with chronic constipation: a multicentre, randomised, double-blind, placebo-controlled study","volume":"15","author":"Salo","year":"2024","journal-title":"Benef Microbes."},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13762","article-title":"Functional Constipation Guidelines Working Group. European society of neurogastroenterology and motility guidelines on functional constipation in adults","volume":"32","author":"Serra","year":"2020","journal-title":"Neurogastroenterol Motil."},{"key":"B44","doi-asserted-by":"publisher","first-page":"e13762","DOI":"10.1111\/nmo.13762","article-title":"European society of neurogastroenterology and motility guidelines on functional constipation in adults","volume":"32","author":"Serra","year":"2020","journal-title":"Neurogastroenterol Motil."},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.1092127","article-title":"Parkinson\u2019s disease constipation effect of electroacupuncture at ST25 through colonic motility and enteric neuropathology","volume":"13","author":"Song","year":"2023","journal-title":"Front. Neurol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.14309\/ajg.0000000000000947","article-title":"Myths and misconceptions about constipation: A new view for the 2020s","volume":"115","author":"Staller","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1016\/j.cgh.2021.10.024","article-title":"Chronic constipation as a risk factor for colorectal cancer: results from a nationwide, case-control study","volume":"20","author":"Staller","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1007\/s00535-012-0627-7","article-title":"Altered neuro-endocrine-immune pathways in the irritable bowel syndrome: the top-down and the bottom-up model","volume":"47","author":"Stasi","year":"2012","journal-title":"J. Gastroenterology"},{"key":"B49","doi-asserted-by":"publisher","first-page":"561","DOI":"10.14309\/ajg.0000000000002028","article-title":"Usefulness of bifidobacterium longum BB536 in elderly individuals with chronic constipation: A randomized controlled trial","volume":"118","author":"Takeda","year":"2023","journal-title":"Am. J. Gastroenterol."},{"key":"B50","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1097\/MEG.0000000000002786","article-title":"Clinical effects of chemical drugs, fecal microbiota transplantation, probiotics, dietary fiber, and acupuncture in the treatment of chronic functional constipation: a systematic review and network meta-analysis","volume":"36","author":"Tan","year":"2024","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0171308","article-title":"Fecal microbiota transplantation in patients with slow-transit constipation: A randomized, clinical trial","volume":"12","author":"Tian","year":"2017","journal-title":"PloS One"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.777961","article-title":"Gut metagenome as a potential diagnostic and predictive biomarker in slow transit constipation","volume":"8","author":"Tian","year":"2022","journal-title":"Front. Med. (Lausanne)."},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1177\/1756284820968423","article-title":"Potential role of fecal microbiota in patients with constipation","volume":"13","author":"Tian","year":"2020","journal-title":"Therap Adv. Gastroenterol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"2005","DOI":"10.1038\/s41390-022-02289-0","article-title":"Functional response to a microbial synbiotic in the gastrointestinal system of children: a randomized clinical trial","volume":"93","author":"Tierney","year":"2023","journal-title":"Pediatr. Res."},{"key":"B55","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1038\/s41575-019-0222-y","article-title":"Management of functional constipation in children and adults","volume":"17","author":"Vriesman","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.16303\/j.cnki.1005-4545.2021.09.24","article-title":"Effects of three acupuncture techniques on intestinal neurotransmitters in rats with constipation","volume":"41","author":"Wang","year":"2021","journal-title":"Chin J. Veterinary Med."},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2023.1152435","article-title":"Association between constipation and major depression in adult Americans: evidence from NHANES 2005-2010","volume":"14","author":"Wang","year":"2023","journal-title":"Front. Psychiatry"},{"key":"B58","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.1039\/d1fo03896f","article-title":"A randomised, double-blind, placebo-controlled trial of Bifidobacterium bifidum CCFM16 for manipulation of the gut microbiota and relief from chronic constipation","volume":"13","author":"Wang","year":"2022","journal-title":"Food Funct."},{"key":"B59","doi-asserted-by":"publisher","first-page":"284","DOI":"10.13339\/j.cnki.sglc.20220421.007","article-title":"Oral gastrointestinal multidimensional vibration capsule in the treatment of slow transit constipation preliminary study","volume":"26","author":"Wang","year":"2022","journal-title":"J. Biomed. Eng. Clin."},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/9835654","article-title":"Corrigendum to \u201cPositive effect of electro-acupuncture treatment on gut motility in constipated mice is related to rebalancing the gut microbiota","volume":"2021","author":"Xu","year":"2021","journal-title":"Evid Based Complement Alternat Med."},{"key":"B61","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1016\/j.neurom.2023.11.005","article-title":"Transcutaneous electrical acustimulation improves constipation symptoms and accelerates colonic transit in patients with slow transit constipation through autonomic mechanism","volume":"27","author":"Yang","year":"2024","journal-title":"Neuromodulation."},{"key":"B62","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1053\/j.gastro.2023.10.012","article-title":"High soluble fiber promotes colorectal tumorigenesis through modulating gut microbiota and metabolites in mice","volume":"166","author":"Yang","year":"2024","journal-title":"Gastroenterology."},{"key":"B63","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1016\/j.joim.2021.11.001","article-title":"Effectiveness and safety of acupuncture for treating functional constipation: An overview of systematic reviews","volume":"20","author":"Yao","year":"2022","journal-title":"J. Integr. Med."},{"key":"B64","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/s13205-023-03580-5","article-title":"Brain-bacteria-gut axis and oxidative stress mediated by intestinal mucosal microbiota might be an important mechanism for constipation in mice","volume":"13","author":"Yi","year":"2023","journal-title":"3 Biotech."},{"key":"B65","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1016\/j.jpedsurg.2021.03.024","article-title":"The usefulness of olive oil enema in children with severe chronic constipation","volume":"56","author":"Yokoi","year":"2021","journal-title":"J Pediatr Surg."},{"key":"B66","doi-asserted-by":"publisher","first-page":"2754","DOI":"10.1007\/s10620-018-5139-8","article-title":"Probiotics ameliorate stool consistency in patients with chronic constipation: A randomized, double-blind, placebo-controlled study","volume":"63","author":"Yoon","year":"2018","journal-title":"Dig Dis. Sci."},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1016\/j.jnutbio.2024.109676","article-title":"Effects and mechanisms of sciadonic acid on colonic transit function through regulating 5-HT4\/cAMP\/PKA\/AQP4 signaling pathway in STC model mice","volume":"131","author":"Yu","year":"2024","journal-title":"J. Nutr. Biochem."},{"key":"B68","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1097\/MCG.0000000000001645","article-title":"Efficacy of electroacupuncture compared with transcutaneous electrical stimulation for severe chronic constipation: A randomized controlled pilot trial","volume":"56","author":"Zeng","year":"2022","journal-title":"J. Clin. Gastroenterol."},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.700718","article-title":"Fecal microbiota transplantation modulates the gut flora favoring patients with functional constipation","volume":"12","author":"Zhang","year":"2021","journal-title":"Front. Microbiol"},{"key":"B70","doi-asserted-by":"publisher","first-page":"H956","DOI":"10.1152\/ajpheart.00519.2024","article-title":"Constipation is associated with an increased risk of major adverse cardiac events in a UK population","volume":"327","author":"Zheng","year":"2024","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/7491281","article-title":"Electroacupuncture for women with chronic severe functional constipation: subgroup analysis of a randomized controlled trial","volume":"2019","author":"Zhou","year":"2019","journal-title":"BioMed. Res. Int."},{"key":"B72","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101407","article-title":"Efficacy and safety of vibrating capsule for functional constipation (VICONS): A randomised, double-blind, placebo-controlled, multicenter trial","volume":"47","author":"Zhu","year":"2022","journal-title":"EClinicalMedicine."}],"updated-by":[{"DOI":"10.3389\/fcimb.2025.1680092","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000}}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1565801\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T06:51:05Z","timestamp":1756104665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2025.1565801\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":72,"alternative-id":["10.3389\/fcimb.2025.1565801"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2025.1565801","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]},"article-number":"1565801"}}