Probiotics for managing functional abdominal pain disorders in Children

Functional abdominal pain is a type of abdominal pain that is common in children and is not caused by any other medical condition. Researchers believe that probiotics and synbiotics can alter the bacterial colonies in the gut and help reduce inflammation and improve gut function, ultimately reducing functional symptoms. The present Cochrane review assessed the effectiveness and safety of probiotics in treating functional abdominal pain disorders in children. The review searched various databases for randomized controlled trials comparing probiotic preparations (including synbiotics) to placebo or other treatments in children aged 4 to 18 years with a diagnosis of functional abdominal pain disorder. It looked for treatment success, complete resolution of pain, improvement in pain severity and frequency, adverse events, school performance, social and psychological functioning, and quality of life. The review analyzed 18 randomized controlled trials involving a total of 1309 patients.

The authors found that probiotics and synbiotics may be more effective than a placebo in gaining treatment success, but the evidence remains of low certainty. However, they found little to no difference between probiotics or synbiotics and placebo in the complete resolution of pain. The evidence on the impact of probiotics or synbiotics on the episodes and severity of pain was of very low certainty due to considerable unexplained heterogeneity or imprecision.

They found no studies that reported serious adverse events, but the evidence on adverse effects remained of very low certainty; thus, this review could not make any conclusions. Further targeted and appropriately designed RCTs must fill the gaps in the evidence base, including studies to investigate long-term follow-up of patients and the safety of specific strains that are not yet investigated.

Key conclusions from the review-

• Probiotics may be better than placebos in easing stomach pain in children with functional abdominal pain.
• Synbiotics may be better than placebo in easing stomach pain in children with functional abdominal pain.

Gordon M, Wallace C, Sinopoulou V, Akobeng AK. Probiotics for management of functional abdominal pain disorders in children. Cochrane Database of Systematic Reviews. 2023. https://doi.org/10.1002/14651858.CD012849.pub2