Gut Microbiota in the Diagnosis and Management of Chronic Constipation: An Integrated Perspective from Mechanisms to Interventions

Chronic constipation represents a major clinical and public health challenge within the field of gastroenterology, affecting up to one in seven individuals globally. It is a multifactorial condition that encompasses slow-transit constipation, defecatory dysfunction, and drug-induced variants, all contributing to significant physical discomfort and reduced quality of life. Traditional diagnostic and therapeutic pathways rely primarily on symptom-based frameworks and physiological testing, which often fail to capture the underlying biological heterogeneity of the disorder. In recent years, the gut microbiota has been recognised as an important determinant of intestinal motility, fluid secretion, and neuroimmune communication. Emerging data highlight that compositional and functional alterations of intestinal microbes may not only reflect disease state but also play a causative role in its development. However, validated biomarkers and mechanistic clarity remain limited, leaving a crucial gap in translating microbiome science into clinical applications.Recent studies using multi-omics approaches, including metagenomics, metabolomics and transcriptomics, have revealed consistent microbial and metabolic patterns linked to chronic constipation. Reduced abundance of short-chain fatty acid-producing genera, altered bile acid transformation, and shifts in neurotransmitter metabolism are repeatedly observed features. These findings point toward a disrupted interplay between microbial metabolites and host signalling pathways regulating gut motility and the gut–brain axis. Interventional studies investigating diet modification, probiotics, prebiotics, synbiotics, and faecal microbiota transplantation have shown promise, but their mechanistic basis and reproducibility across populations are still incompletely understood. As the field advances, establishing robust diagnostic biomarkers and identifying patient-specific microbial signatures are key unmet needs.This Research Topic aims to consolidate mechanistic, diagnostic, and therapeutic research on the role of the gut microbiota in chronic constipation. By bridging fundamental microbial ecology and clinical gastroenterology, it seeks to elucidate how distinct microbial taxa and their metabolites influence intestinal physiology, define microbial biomarkers for patient stratification, and evaluate microbiota-targeted interventions with translational potential. Ultimately, this Research Topic strives to promote an integrated framework that transforms emerging microbiome science into personalized management strategies for chronic constipation.To gather further insights into the microbiota–constipation interface, we welcome original research articles, systematic reviews, reviews, perspectives and all type of articles accepted by the journal, spanning basic, translational, and clinical research. Submissions may include, but are not limited to, the following themes:o Characterization of gut microbial communities and metabolomic profiles in chronic constipationo Mechanistic elucidation of microbial metabolites (short-chain fatty acids, bile acids, neurotransmitters, and gases) in motility regulationo Gut–brain axis pathways involved in constipation pathophysiologyo Microbiome-based biomarkers for diagnosis, subtype differentiation, and treatment predictiono Evaluation of dietary, probiotic, prebiotic, synbiotic, and faecal microbiota transplantation interventionso Integrative multi-omics and computational models linking host–microbiome interactionso Influence of genetics, diet, and ageing on gut microbial composition and constipation susceptibility Topic editors: Haiming Fang, Jinxin Zhao, Jiayuan Huang, Chengu Niu Source: https://www.frontiersin.org/research-topics/82106/gut-microbiota-in-the-diagnosis-and-management-of-chronic-constipation-an-integrated-perspective-from-mechanisms-to-interventions