Bottom-Up Design of Prebiotics and Probiotics: An Intestinal Microbiota-Centered Approach to Chronic and Functional Constipation Management.

Chronic constipation (CC) and functional constipation (FC) are common gastrointestinal disorders that significantly affect quality of life. This study investigates the intestinal microbiota characteristics in CC and FC patients, revealing microbial imbalances characterized by reduced beneficial taxa, such as Acinetobacter, Blautia, Dorea formicigenerans, Eubacterium ramulus, and Halomonas, alongside increased levels of Alistipes, Holdemanella, Parabacteroides, Pseudomonas, Streptococcus, and so on. These findings highlight dysbiosis as a critical factor in constipation pathogenesis and provide a foundation for the bottom-up design of targeted probiotics and prebiotics. Potential therapeutic strategies include tailored probiotic formulations to replenish deficient taxa and the application of prebiotics to restore microbial balance. Additionally, the role of microbial metabolites, particularly short-chain fatty acids, and the microbiota-gut-brain axis offers further insight into mechanisms underlying symptom modulation. The integration of artificial intelligence enhances precision in probiotic design, enabling the prediction of strain-specific combinations optimized for therapeutic efficacy. This microbiota-centered approach underscores the potential for personalized interventions in addressing dysbiosis and advancing innovative management for CC and FC.