Use of probiotics in the treatment of functional abdominal pain in children

Background: 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.

Methods: 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 rhamnosus GG and Lactobacillus reuteri DSM 17938 were the only two probiotic strains investigated.

Results: 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 taking L. reuteri DSM 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. reuteri was 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.




Use of probiotics in the treatment of functional abdominal pain in children-systematic review and meta-analysis. Trivić I, Niseteo T, Jadrešin O, Hojsak I. Eur J Pediatr. 2021 Feb;180(2):339-351. doi: 10.1007/s00431-020-03809-y.

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