Constipation is a common gastrointestinal disorder characterized by infrequent bowel movements, difficult stool passage, excessive straining, and impaired colonic transit. Increasing evidence indicates that gut microbiota-derived metabolites are active regulators of intestinal motility rather than passive byproducts of luminal fermentation. In constipation, dysbiosis is often accompanied by reduced saccharolytic fermentation, altered bile acid biotransformation, disturbed tryptophan metabolism, and enhanced methanogenesis, all of which may contribute to delayed transit and stool desiccation. Short-chain fatty acids, secondary bile acids, tryptophan-derived metabolites, and methane influence motility through effects on enterochromaffin cells, serotonin biosynthesis, epithelial secretion, enteric neural circuits, mucosal immunity, and smooth muscle activity. These mechanistic insights have therapeutic implications. Dietary modulation, probiotics, synbiotics, fecal microbiota transplantation, and bile acid-targeted therapies may improve constipation partly by restoring a more favorable metabolite milieu. However, the causal role of individual metabolites in human constipation remains incompletely defined, and clinical responses are heterogeneous. This review summarizes current evidence on how gut microbiota-derived metabolites regulate intestinal motility in constipation and discusses the translational potential of metabolite-informed therapeutic strategies.
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Liu, S., Song, B., Yang, Y., Wei, H., Li, L., Yang, Y., Huang, X., Song, X., Alhoot, M. A. (2025) Gut Microbiota-derived Metabolites Regulate Intestinal Motility in Constipation: Mechanisms and Therapeutic Implications. Journal of Disease and Public Health, 1(3), 9-14.