TOPLINE

Probiotic supplementation modestly reduced pain intensity and weekly pain episodes in children with functional abdominal pain-related disorders but offered limited clinical benefit over placebo, a meta-analysis suggests.

METHODOLOGY

• Researchers conducted a meta-analysis of 21 randomized controlled trials published from 2005 to 2025, involving 1899 children with functional abdominal pain-related disorders who completed treatment.
• Functional abdominal pain disorders included irritable bowel syndrome, functional abdominal pain not otherwise specified, functional dyspepsia, or abdominal migraine.
• Children received either placebo or probiotic or synbiotic supplements; treatment duration ranged from 2 to 12 weeks.
• Primary outcome was change in abdominal pain severity; secondary outcomes included frequency of pain episodes, treatment success, and complete resolution or improvement of symptoms.

TAKEAWAY

• Probiotics modestly reduced pain intensity compared with placebo (mean difference [MD], −0.80; 95% CI, −1.45 to −0.15), and Lactobacillus rhamnosus GG showed the greatest benefit (MD, −1.15; 95% CI, −1.63 to −0.68).
• Probiotic supplementation slightly reduced the number of pain episodes per week (MD, −1.02; 95% CI, −1.88 to −0.17) and increased complete symptom resolution (risk ratio, 1.56; 95% CI, 1.07-2.27), corresponding to a number needed to treat of approximately 7.
• When success was defined as symptom improvement according to author-defined thresholds, probiotic supplementation was not associated with different response rates compared with placebo.
• No serious adverse events were reported across the included trials, and probiotic therapy was generally well tolerated, with only occasional mild gastrointestinal symptoms reported.

IN PRACTICE

"Probiotics are safe and can be used alongside standard treatments," the authors wrote.

SOURCE

The study was led by Nour Balasan, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo," Trieste, Italy. It was published online on July 20 in European Journal of Pediatrics.

LIMITATIONS

Substantial clinical and methodological heterogeneity was observed across trials. Certainty of evidence was rated as low to moderate across outcomes. The high placebo response rate and reliance on subjective patient-reported outcomes further limit interpretation of clinical benefit.

DISCLOSURES

The study was supported by the Italian Ministry of Health through a contribution to the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.