Use of probiotics in the treatment of functional abdominal pain in children-systematic review and meta-analysis

Functional abdominal pain is a very frequent functional gastrointestinal disorder but still without adequate treatment options. Therefore, the main aim of this systematic review and meta-analysis was to evaluate strain-specific probiotic effects on functional abdominal pain in children. This was a systematic review and meta-analysis of randomized controlled trials published in a period up to 1st of April 2020 that analyzed probiotic interventions for pediatric functional abdominal pain. We included 9 randomized controlled trials (a total of 702 children, 506 with functional abdominal pain; 4 to 18 years); 8 studies were available for meta-analysis (a total of 641 children).Lactobacillus rhamnosusGG andLactobacillus reuteriDSM 17938 were the only two probiotic strains investigated. Significant reduction in pain intensity (6 trials,n = 380, mean difference - 1.24, 95% CI - 2.35 to - 0.13) and increase in number of days without pain (2 trials,n = 101, mean difference 26.42, 95% CI 22.67 to 30.17) were found in children takingL. reuteriDSM 17938. For all other outcomes, there were no significant differences between probiotic and placebo. Conclusion:Based on the available evidence, no firm conclusions can be given; however,L. reuteriwas proven to decrease the pain intensity in children with functional abdominal pain. Further trials regarding long-term outcomes, possibly involving longer interventions, are needed. What is Known: Previously published systematic reviews have suggested that probiotics may have an effect on the pain in children with functional gastrointestinal disorders, but limited data exist on strain-specific effects. What is New: This systematic review provides evidence on the probiotic use on the strain-specific level. This systematic review showed that the use of Lactobacillus reuteri DSM 17938 modestly reduces the pain intensity in children with functional abdominal pain.

Automated summary

Functional abdominal pain is a common functional gastrointestinal disorder with limited treatment options. This systematic review and meta-analysis found that Lactobacillus reuteri DSM 17938 can modestly reduce pain intensity in children with functional abdominal pain. Future trials on long-term outcomes are needed to further investigate the effects of probiotics on pediatric abdominal pain.