Probiotics for management of functional abdominal pain disorders in children

Chris Wallace, Morris Gordon, Vassiliki Sinopoulou, Anthony K Akobeng, Chris Wallace, Morris Gordon, Vassiliki Sinopoulou, Anthony K Akobeng

Abstract

Background: Functional abdominal pain is pain occurring in the abdomen that cannot be fully explained by another medical condition and is common in children. It has been hypothesised that the use of micro-organisms, such as probiotics and synbiotics (a mixture of probiotics and prebiotics), might change the composition of bacterial colonies in the bowel and reduce inflammation, as well as promote normal gut physiology and reduce functional symptoms.

Objectives: To assess the efficacy and safety of probiotics in the treatment of functional abdominal pain disorders in children.

Search methods: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and two clinical trials registers from inception to October 2021.

Selection criteria: Randomised controlled trials (RCTs) that compare probiotic preparations (including synbiotics) to placebo, no treatment or any other interventional preparation in patients aged between 4 and 18 years of age with a diagnosis of functional abdominal pain disorder according to the Rome II, Rome III or Rome IV criteria.

Data collection and analysis: The primary outcomes were treatment success as defined by the primary studies, complete resolution of pain, improvement in the severity of pain and improvement in the frequency of pain. Secondary outcomes included serious adverse events, withdrawal due to adverse events, adverse events, school performance or change in school performance or attendance, social and psychological functioning or change in social and psychological functioning, and quality of life or change in quality life measured using any validated scoring tool. For dichotomous outcomes, we calculated the risk ratio (RR) and corresponding 95% confidence interval (95% CI). For continuous outcomes, we calculated the mean difference (MD) and corresponding 95% CI.

Main results: We included 18 RCTs assessing the effectiveness of probiotics and synbiotics in reducing the severity and frequency of pain, involving a total of 1309 patients. Probiotics may achieve more treatment success when compared with placebo at the end of the treatment, with 50% success in the probiotic group versus 33% success in the placebo group (RR 1.57, 95% CI 1.05 to 2.36; 554 participants; 6 studies; I2 = 70%; low-certainty evidence). It is not clear whether probiotics are more effective than placebo for complete resolution of pain, with 42% success in the probiotic group versus 27% success in the placebo group (RR 1.55, 95% CI 0.94 to 2.56; 460 participants; 6 studies; I2 = 70%; very low-certainty evidence). We judged the evidence to be of very low certainty due to high inconsistency and risk of bias. We were unable to draw meaningful conclusions from our meta-analyses of the pain severity and pain frequency outcomes due to very high unexplained heterogeneity leading to very low-certainty evidence. None of the included studies reported serious adverse events. Meta-analysis showed no difference in withdrawals due to adverse events between probiotics (1/275) and placebo (1/269) (RR 1.00, 95% CI 0.07 to 15.12). The results were identical for the total patients with any reported adverse event outcome. However, these results are of very low certainty due to imprecision from the very low numbers of events and risk of bias. Synbiotics may result in more treatment success at study end when compared with placebo, with 47% success in the probiotic group versus 35% success in the placebo group (RR 1.34, 95% CI 1.03 to 1.74; 310 participants; 4 studies; I2 = 0%; low certainty). One study used Bifidobacterium coagulans/fructo-oligosaccharide, one used Bifidobacterium lactis/inulin, one used Lactobacillus rhamnosus GG/inulin and in one study this was not stated). Synbiotics may result in little difference in complete resolution of pain at study end when compared with placebo, with 52% success in the probiotic group versus 32% success in the placebo group (RR 1.65, 95% CI 0.97 to 2.81; 131 participants; 2 studies; I2 = 18%; low-certainty evidence). We were unable to draw meaningful conclusions from our meta-analyses of pain severity or frequency of pain due to very high unexplained heterogeneity leading to very low-certainty evidence. None of the included studies reported serious adverse events. Meta-analysis showed little to no difference in withdrawals due to adverse events between synbiotics (8/155) and placebo (1/147) (RR 4.58, 95% CI 0.80 to 26.19), or in any reported adverse events (3/96 versus 1/93, RR 2.88, 95% CI 0.32 to 25.92). These results are of very low certainty due to imprecision from the very low numbers of events and risk of bias. There were insufficient data to analyse by subgroups of specific functional abdominal pain syndrome (irritable bowel syndrome, functional dyspepsia, abdominal migraine, functional abdominal pain - not otherwise specified) or by specific strain of probiotic. There was insufficient evidence on school performance or change in school performance/attendance, social and psychological functioning, or quality of life to draw conclusions about the effects of probiotics or synbiotics on these outcomes.

Authors' conclusions: The results from this review demonstrate that probiotics and synbiotics may be more efficacious than placebo in achieving treatment success, but the evidence is of low certainty. The evidence demonstrates little to no difference between probiotics or synbiotics and placebo in complete resolution of pain. We were unable to draw meaningful conclusions about the impact of probiotics or synbiotics on the frequency and severity of pain as the evidence was all of very low certainty due to significant unexplained heterogeneity or imprecision. There were no reported cases of serious adverse events when using probiotics or synbiotics amongst the included studies, although a review of RCTs may not be the best context to assess long-term safety. The available evidence on adverse effects was of very low certainty and no conclusions could be made in this review. Safety will always be a priority in paediatric populations when considering any treatment. Reporting of all adverse events, adverse events needing withdrawal, serious adverse events and, particularly, long-term safety outcomes are vital to meaningfully move forward the evidence base in this field. Further targeted and appropriately designed RCTs are needed to address the gaps in the evidence base. In particular, appropriate powering of studies to confirm the safety of specific strains not yet investigated and studies to investigate long-term follow-up of patients are both warranted.

Conflict of interest statement

Chris Wallace: none known.

Morris Gordon: no relevant interests; Co‐ordinating Editor, Cochrane Gut.

Vassiliki Sinopoulou: none known.

Anthony K Akobeng: no relevant interests; Physician, Sidra Medicine; Co‐ordinating Editor, Cochrane Gut.

Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Figures

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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1.1. Analysis
1.1. Analysis
Comparison 1: Probiotic versus placebo, Outcome 1: Treatment success
1.2. Analysis
1.2. Analysis
Comparison 1: Probiotic versus placebo, Outcome 2: Treatment success (sensitivity analysis: fixed‐effect model)
1.3. Analysis
1.3. Analysis
Comparison 1: Probiotic versus placebo, Outcome 3: Complete resolution of pain
1.4. Analysis
1.4. Analysis
Comparison 1: Probiotic versus placebo, Outcome 4: Complete resolution of pain (sensitivity analysis: risk of bias)
1.5. Analysis
1.5. Analysis
Comparison 1: Probiotic versus placebo, Outcome 5: Severity of pain
1.6. Analysis
1.6. Analysis
Comparison 1: Probiotic versus placebo, Outcome 6: Frequency of pain (episodes per week)
1.7. Analysis
1.7. Analysis
Comparison 1: Probiotic versus placebo, Outcome 7: Frequency of pain (episodes per week) (sensitivity analysis: risk of bias)
1.8. Analysis
1.8. Analysis
Comparison 1: Probiotic versus placebo, Outcome 8: Withdrawals due to adverse events
1.9. Analysis
1.9. Analysis
Comparison 1: Probiotic versus placebo, Outcome 9: Adverse events
2.1. Analysis
2.1. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 1: Treatment success
2.2. Analysis
2.2. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 2: Treatment success (sensitivity analysis: fixed‐effect model)
2.3. Analysis
2.3. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 3: Treatment success (sensitivity analysis: risk of bias)
2.4. Analysis
2.4. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 4: Complete resolution of pain
2.5. Analysis
2.5. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 5: Complete resolution of pain (sensitivity analysis: risk of bias)
2.6. Analysis
2.6. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 6: Severity of pain
2.7. Analysis
2.7. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 7: Frequency of pain (episodes per week)
2.8. Analysis
2.8. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 8: Withdrawals due to adverse events
2.9. Analysis
2.9. Analysis
Comparison 2: Synbiotics versus placebo, Outcome 9: Adverse events

References

References to studies included in this review Asgarshirazi 2015 {published data only}

    1. Asgarshirazi M, Shariat M, Dalili H. Comparison of the effects of ph-dependent peppermint oil and synbiotic lactol (Bacillus coagulans + fructooligosaccharides) on childhood functional abdominal pain: a randomized placebo-controlled study. Iranian Red Crescent Medical Journal 2015;17(4).
Baştürk 2016 {published data only}
    1. Baştürk A, Artan R, Yilmaz A. Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: a randomized controlled trial. Turkish Journal of Gastroenterology 2016;27(5):439-43.
    1. Baştürk A, Artan R, Yilmaz A. Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: A randomized controlled trial. Turkish Journal of Gastroenterology 2016;27(5):439-43.
    1. Sinopoulou V (University of Central Lancashire). [personal communication]. Conversation with: Baştürk A (Akdeniz University School of Medicine, Antalya, Turkey) 10 March 2020.
Bauserman 2005 {published data only}
    1. Bauserman M, Michail S. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. Journal of Pediatrics 2005;147(2):197-201.
Eftekhari 2015 {published data only}
    1. Eftekhari K, Vahedi Z, Aghdam MK, Diaz DN. A randomised double-blind placebo-controlled trial of Lactobacillus reuteri for chronic functional abdominal pain in children. Iranian Journal of Pediatrics 2015;25(6):2616.
Francavilla 2010 {published data only}
    1. Francavilla R, Magista AM, Lionetti E, De Canio A, Castellaneta S, Cavallo L. Lactobacillus GG in children with chronic abdominal pain: a double-blind placebo-controlled control trial. Digestive and Liver Disease 2009;41S(Suppl 3):S217.
    1. Francavilla R, Miniello V, Magistá AM, De Canio A, Bucci N, Gagliardi F, et al. A randomised controlled trial of Lactobacillus GG in children with functional abdominal pain. Pediatrics 2010;126(6):e1445.
    1. NCT00876291. Efficacy of Lactobacillus GG (LGG) in children with abdominal pain (LGGDAR). (first received 6 April 2009).
    1. NCT01671137 . Probiotic for the prevention of functional disorders in childhood. (first received 23 August 2012).
Gawrońska 2007 {published data only}
    1. Gawrońska A, Dziechciarz P, Horvath A, Szajewska H. A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children. Alimentary Pharmacology and Therapeutics 2007;25(2):177-84.
Giannetti 2017 {published data only}
    1. Giannetti E, Alessandrella A, De Giovanni D, Campanozzi A, Staiano A, Miele E. A multicenter, randomized, double-blind, placebo controlled, crossover trial on the efficacy of a mixture of three bifidobacteria in children with functional abdominal pain. Digestive and Liver Disease 2014;46:e80.
    1. Giannetti E, Marco M, Annalisa A, Caterina S, Donatella G, Angelo C, et al. A mixture of 3 bifidobacteria decreases abdominal pain and improves the quality of life in children with irritable bowel syndrome: a multicenter, randomized, double-blind, placebo-controlled, crossover trial. Journal of Clinical Gastroenterology 2017;51(1):e5-10.
Guandalini 2010 {published data only}
    1. Guandalini S, Magazzù G, Chiaro A, La Balestria V, Di Nardo G, Gopalan S, et al. VSL #3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind crossover study. Journal of Pediatric Gastroenterology and Nutrition 2010;51(1):24-30.
Jadrešin 2017 {published data only}
    1. Jadrešin O, Hojsak I, Mišak Z, Kekez A J, Trbojević T, Ivković L, et al. Lactobacillus reuteri DSM 17938 in the treatment of functional abdominal pain in children-randomized, double-blind, placebo-controlled study. ESPGHAN 49th Annual Meeting Poster Exhibition 2016;62:470.
    1. Jadrešin O, Hojsak I, Mišak Z, Kekez A J, Trbojević T, Ivković L, Kolaček S. Lactobacillus reuteri DSM 17938 in the treatment of functional abdominal pain in children: RCT study. Journal of Pediatric Gastroenterology and Nutrition 2017;64(6):925-9.
    1. NCT01587846 . Lactobacillus reuteri in treatment of functional abdominal pain and chronic constipation in children. (first received 30 April 2012).
Jadrešin 2020 {published data only}
    1. Jadrešin O, Sila S, Trivić I, Mišak Z, Kolaček S, Hojsak I. Lactobacillus reuteri DSM 17938 is effective in the treatment of functional abdominal pain in children: results of the double-blind randomized study. Clinical Nutrition 2020;39(12):3645-51.
Kianifar 2015 {published data only}
    1. IRCT201205219825N1 . Evaluation of probiotics effect on non-organic chronic abdominal pain in children. (first received 5 July 2012).
    1. Kianifar H, Jafari SA, Kiani M, Ahanchian H, Ghasemi SV, Grover Z, et al. Probiotic for irritable bowel syndrome in pediatric patients: a randomized controlled clinical trial. Electronic Physician 2015;7(5):1255-60.
Maragkoudaki 2017 {published data only}
    1. Maragkoudaki M, Chouliaras G, Orel R, Horvath A, Szajewska H, Papadapoulou A. Lactobacillus reuteri DSM 17938 and a placebo both significantly reduced symptoms in children with functional abdominal pain. Acta Paediatrica 2017;106(11):1857-62.
    1. Maragkoudaki M, Chouliaras G, Orel R, Horvath A, Szajewska H, Papadopoulou A. Lactobacilllus reuteri DSM 17938 for the management of functional abdominal pain (FAP) in children: a multicenter randomized controlled trial. ESPGHAN 49th Annual Meeting 2016;62:460.
    1. NCT01719107 . Efficacy of dietary supplementation with Lactobacilllus reuteri DSM 17938 on functional abdominal pain (FAP) in children. (first received 1 November 2012).
Otuzbir 2016 {published data only}
    1. Otuzbir A, Ozkan TB, Ozgur T, Sahin U, Altay D, Budak F, et al. Efficiency and immunologic effects of synbiotics in children with functional abdominal pain. Journal of Pediatric Gastroenterology and Nutrition 2016;62:426.
Rahmani 2020 {published data only}
    1. Motamed F, Gouran A. Evaluation of the effects of Lactobacillus reuteri on children with recurrent abdominal pain (RAP). ESPGHAN 52nd Annual Meeting Poster Exhibition 2019;68:409.
    1. Rahmani P, Ghouran-orimi A, Motamed F, Moradzadeh A. Evaluating the effects of probiotics in pediatrics with recurrent abdominal pain. Clinical and Experimental Pediatrics 2020;63(12):485-90.
Romano 2014 {published data only}
    1. Romano C, Ferrau' V, Cavataio F, Iacono G, Spina M, Lionetti E, et al. Lactobacillus reuteri in children with functional abdominal pain (FAP). Journal of Paediatrics and Child Health 2014;50(10):e68-71.
Sabbi 2012 {published data only}
    1. Sabbi T, Palumbo M. The use of Lactobacillus GG in children with functional abdominal pain: a double-blind randomized control trial. Digestive and Liver Disease 2011;43(Suppl 5):S412.
    1. Sabbi T. The use of Lactobacillus GG in children with functional abdominal pain: a double‐blind randomized control trial. Clinical Nutrition Supplements 2011;6(1):198.
    1. Sabbi T. The use of Lactobacillus GG in children with functional abdominal pain: a double-blind randomized control trial. Digestive and Liver Disease 2012;44:S207-8.
Saneian 2015 {published data only}
    1. Saneian H, Pourmoghaddas Z, Roohafza H, Gholamrezaei A. Synbiotic containing Bacillus coagulans and fructo-oligosaccharides for functional abdominal pain in children. Gastroenterology and Hepatology 2015;8(1):56-65.
Weizman 2016 {published data only}
    1. NCT01180556 . Effect of probiotics in childhood abdominal pain. (first received 12 August 2010).
    1. Weizman Z, Abu-Abed J, Binsztok M. Lactobacillus reuteri DSM 17938 for the management of functional abdominal pain in childhood: a randomized, double-blind, placebo-controlled trial. Journal of Pediatrics 2016;174:160-4.
References to studies excluded from this review Abu‐Salih 2011 {published data only}
    1. Abu-Salih M, Dickinson CJ. Lactobacillus GG may improve frequency and severity of pain in children with functional abdominal pain. Journal of Pediatrics 2011;159(1):165-6.
Anonymous 2010 {published data only}
    1. Anonymous. Ethical nutrients IBS support: same great product; brand new advertising campaign! Australian Journal of Pharmacy 2010;91(1087):24.
Anuradha 2005 {published data only}
    1. Anuradha S, Rajeshwari K. Probiotics in health and disease. Journal, Indian Academy of Clinical Medicine 2005;6(1):67-72.
Baştürk 2017 {published data only}
    1. Baştürk A, Artan R, Atalay A, Yilmaz A. Investigation of the efficacy of synbiotics in the treatment of functional constipation in children: a randomized double-blind placebo-controlled study. Turkish Journal of Gastroenterology 2017;28(5):388-93.
Berger 2007 {published data only}
    1. Berger MY, Gieteling MJ, Benninga MA. Chronic abdominal pain in children. BMJ 2007;334(7601):997-1002.
Cash 2011 {published data only}
    1. Cash BD. Non-absorbed antibiotic for irritable bowel syndrome. Current Gastroenterology Reports 2011;13(5):398-401.
Cha 2012 {published data only}
    1. Cha BK, Jung SM, Choi CH, Song ID, Lee HW, Kim HJ, et al. The effect of a multispecies probiotic mixture on the symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. Journal of Clinical Gastroenterology 2012;46(3):220-7.
Charrois 2006 {published data only}
    1. Charrois TL, Sandhu G, Vohra S. Probiotics. Pediatrics in Review 2006;27(4):137-9.
Chassany 2008 {published data only}
    1. Chassany O, Matuchansky C. Probiotics and the irritable bowel syndrome. Alimentary Pharmacology and Therapeutics 2008;27(7):616-7.
Choi 2015 {published data only}
    1. Choi CH, Kwon JG, Kim SK, Myung SJ, Park KS, Sohn CI, et al. Efficacy of combination therapy with probiotics and mosapride in patients with IBS without diarrhoea: a randomized, double-blind, placebo-controlled, multicenter, phase II trial. Neurogastroenterology & Motility 2015;27(5):705-16.
Comito 2011 {published data only}
    1. Comito D, Famiani A, Calamara S, Cardile S, Ferrau V, Chiaro A, et al. Efficacy of complementary therapy with partially hydrolyzed guar gum (PHGG) in functional gastrointestinal disorders (FGID): a first pediatric randomized placebo controlled trial (RCT). Digestive and Liver Disease 2011;43:S443-4.
Drossman 2011 {published data only}
    1. Drossman DA. Rifaximin for treatment of irritable bowel syndrome. Gastroenterology and Hepatology 2011;7(3):180-1.
Enck 2007 {published data only}
    1. Enck P, Menke G, Zimmermann K, Martens U, Klosterhalfen S. Probiotic therapy of the irritable bowel syndrome (IBS). Zeitschrift für Gastroenterologie 2007;45(8):758.
Enck 2009 {published data only}
    1. Enck P, Zimmermann K, Menke G, Klosterhalfen S. Randomized controlled treatment trial of irritable bowel syndrome with a probiotic E.-coli preparation (DSM17252) compared to placebo. Zeitschrift für Gastroenterologie 2009;47(2):209-14.
Faber 2003 {published data only}
    1. Faber SM. Are probiotics useful in irritable bowel syndrome? Journal of Clinical Gastroenterology 2003;37(1):93-4.
Ford 2012 {published data only}
    1. Ford AC, Talley NJ. Irritable bowel syndrome. BMJ 2012;345(7873):e5836.
Han 2016 {published data only}
    1. Han K, Wang J, Seo JG, Kim H. Efficacy of double-coated probiotics for irritable bowel syndrome: a randomized double-blind controlled trial. Journal of Gastroenterology 2017;52(4):432–43.
Kajander 2008 {published data only}
    1. Kajander K, Vapaatalo H, Korpela R. Probiotics and the irritable bowel syndrome. Alimentary Pharmacology and Therapeutics 2008;27(7):617-8.
Le Neve 2016 {published data only}
    1. Le Neve B, Brazeilles R, Guyonnet D, Ohman L, Tornblom H, Simren M. Effect of a fermented milk product containing Bifidobacterium lactis CNCM I-2494 in patients with irritable bowel syndrome (IBS): a randomized, double-blinded, placebo-controlled trial. Gastroenterology 2016;150(4):S697.
Mezzasalma 2016 {published data only}
    1. Mezzasalma Y, Manfrini E, Ferri E, Sandionigi A, La Ferla B, Schiano I, et al. A randomized, double-blind, placebo-controlled trial: the efficacy of multispecies probiotic supplementation in alleviating symptoms of irritable bowel syndrome associated with constipation. Biomed Research International 2016;2016:4740907.
NCT04922476 {published data only}
    1. NCT04922476. Effect of 35624® Alflorex® in functional gastrointestinal disorders (FGIDs) in children. (first received 10 June 2021).
Pélerin 2016 {published data only}
    1. Pélerin F, Desreumaux P. Probiotic yeast therapy for irritable bowel syndrome. Journal of Neurogastroenterology and Motility 2016;22(3):542.
Rose 2011 {published data only}
    1. Rose MA. Lactobacillus rhamnosus GG reduces frequency and severity of abdominal pain compared with placebo in children with irritable bowel syndrome. BMJ Evidence-Based Medicine 2011;16(5):141-2.
Schmulson 2011 {published data only}
    1. Schmulson M, Chang L. Review article: the treatment of functional abdominal bloating and distension. Alimentary Pharmacology and Therapeutics 2011;33(10):1071-86.
Sen 2002 {published data only}
    1. Sen S, Mullan MM, Parker TJ, Woolner JT, Tarry SA, Hunter JO. Effects of Lactobacillus plantarum 299V on symptoms and colonic fermentation in irritable bowel syndrome (IBS). Digestive Diseases and Sciences 2002;47(11):2615-20.
Spiller 2016 {published data only}
    1. Spiller R, Pélerin F, Decherf AC, Maudet C, Housez B, Cazaubiel M, et al. Randomized double blind placebo-controlled trial of Saccharomyces cerevisiae CNCM I-3856 in irritable bowel syndrome: improvement in abdominal pain and bloating in those with predominant constipation. United European Gastroenterology Journal 2016;4(3):353-62.
Wegner 2018 {published data only}
    1. Wegner A, Banaszkiewicz A, Kierkus J, Landowski P, Korlatowicz- Bilar A, Wiecek S, et al. Effectiveness of lactobacillus reuteri in the treatment of functional constipation in children: a randomized, double-blind, placebo-controlled, multicenter trial. 23rd United European Gastroenterology Week Barcelona 2015;3(5):A20.
    1. Wegner A, Banaszkiewicz A, Kierkus J, Landowski P, Korlatowicz-Bilar A, Wiecek S, et al. The effectiveness of Lactobacillus reuteri DSM 17938 as an adjunct to macrogol in the treatment of functional constipation in children. A randomized, double-blind, placebo-controlled, multicentre trial. Clinics and Research in Hepatology and Gastroenterology 2018;42(5):494-500.
Yoon 2014 {published data only}
    1. Yoon JS, Sohn W, Lee OY, Lee SP, Lee KN, Jun DW, et al. Effect of multispecies probiotics on irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. Journal of Gastroenterology and Hepatology 2014;29(1):52-9.
Yoon 2015 {published data only}
    1. Yoon H, Park YS, Lee DH, Seo JG, Shin CM, Kim N. Effect of administering a multi-species probiotic mixture on the change in fecal microbiota and symptoms of irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. Journal of Clinical Biochemistry and Nutrition 2015;57(2):129-34.
References to studies awaiting assessment Chao 2011 {published data only}
    1. Chao HC, Chen CC, Chen SY. The effect of probiotics on serotonin signalling in plasma and intestinal GG tissue in pediatric irritable bowel syndrome. Journal of Pediatric Gastroenterology and Nutrition 2011;52:165.
Gholizadeh 2021 {published data only}
    1. Gholizadeh A, Mehrabani S, Dooki ME, Ahmadi MH. Effect of a synbiotic on functional abdominal pain in childhood. Caspian Journal of Internal Medicine 2021;12(2):194-9.
    1. IRCT20190304042914N1. Assesment the effect of synbiotic in the treatment of functional abdominal pain in children. (first received 25 May 2019).
NCT00793494 {published data only}
    1. NCT00793494 . Efficacy of Probaclac in irritable bowel syndrome in children aged 8 to 18 years (POPSII). (first received 19 November 2008).
NCT02613078 {published data only}
    1. NCT02613078 . Hypnotherapy vs. probiotics in children with IBS and functional abdominal pain. (first received 24 November 2015).
Sudha 2018 {published data only}
    1. Sudha MR, Jayanthi N, Aasin M, Dhanashri RD, Anirudh T. Efficacy of Bacillus coagulans unique IS2 in treatment of irritable bowel syndrome in children: a double blind, randomised placebo controlled study. Beneficial Microbes 2018;9(4):563-72.
References to ongoing studies IRCT20150706023084N14 {published data only}
    1. IRCT20150706023084N14 . Evaluation of the effectiveness of Lactobacillus reuteri probiotics in the treatment of chronic functional abdominal pain in children aged 5 to 15 years. (first received 30 December 2021).
IRCT20200806048325N1 {published data only}
    1. IRCT20200806048325N1 . Comparison of the effect of Prokid with Rotflore sachet in reducing functional abdominal pain in children. (first received 29 September 2020).
Additional references Apley 1958
    1. Apley J, Naish N. Recurrent abdominal pains: a field survey of 1,000 school children. Archives of Disease in Childhood 1958;33(168):165.
Assa 2015
    1. Assa A, Ish-Tov A, Rinawi F, Shamir R. School attendance in children with functional abdominal pain and inflammatory bowel diseases. Journal of Pediatric Gastroenterology and Nutrition 2015;61(5):553-7.
Besselink 2008
    1. Besselink MG, Santvoort HC, Buskens E, Boermeester MA, Goor H, Timmerman HM, et al. Probiotic prophylaxis in predicted severe acute pancreatitis: a randomised, double-blind, placebo-controlled trial. Lancet 2008;23(371):651-9. [DOI: 10.1016/S0140-6736(08)60207-X.]
Boyle 2006
    1. Boyle RJ, Robins-Browne RM, Tang MLK. Probiotic use in clinical practice: what are the risks? American Journal of Clinical Nutrition 2006;83(6):1256-64.
Dore 2019
    1. Dore MP, Bibbò S, Fresi G, Bassotti G, Pes GM. Side effects associated with probiotic use in adult patients with inflammatory bowel disease: a systematic review and meta-analysis of randomized controlled trials. Nutrients 2019;11(12):2913. [DOI: 10.3390/nu11122913]
Drossman 2006
    1. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006;130(5):1377-90.
Drossman 2016
    1. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features, and Rome IV. Gastroenterology 2016;150(6):1262-79.
Drossman 2017
    1. Schmulson M, Drossman D. Rome IV Functional Gastrointestinal Disorders: Disorders of gut-brain interaction. 4 edition. Rome Foundation, Inc, May 2017.
GRADEpro GDT [Computer program]
    1. GRADEpro Guideline Development Tool. Version accessed 26 November 2022. Hamilton (ON): McMaster University (developed by Evidence Prime), 2021. Available at .
Higgins 2011
    1. Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.
Higgins 2021
    1. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from .
Huertas‐Ceballos 2009
    1. Huertas-Ceballos AA, Logan S, Bennett C, Macarthur C. Dietary interventions for recurrent abdominal pain (RAP) and irritable bowel syndrome (IBS) in childhood. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No: CD003019. [DOI: 10.1002/14651858.CD003019.pub3]
Hyams 2016
    1. Hyams JS, Di Lorenzo C, Saps M, Shulman RJ, Staiano A, Tilburg M. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2016;150(6):1456-68.
Korterink 2015
    1. Korterink JJ, Diederen K, Benninga MA, Tabbers MM. Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis. PLOS One 2015;10(5):e0126982.
Martin 2017
    1. Martin AE, Newlove-Delgado TV, Abbott RA, Bethel A, Thompson-Coon J, Whear R, et al. Interventions for recurrent abdominal pain in childhood. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No: CD010973. [DOI: 10.1002/14651858.CD010973.pub2]
Moayyedi 2010
    1. Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut 2010;59:325-32.
Newlove‐Delgado 2017
    1. Newlove-Delgado T, Martin A, Abbott R, Bethel A, Thompson-Coon J, Whear R, et al. Dietary interventions for recurrent abdominal pain in childhood. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No: CD010972. [DOI: 10.1002/14651858.CD010972.pub2]
Newton 2019
    1. Newton E, Schosheim A, Patel S, Chitkara DK, Tilburg MA. The role of psychological factors in pediatric functional abdominal pain disorders. Neurogastroenterology & Motility 2019;31(6):e13538.
Page 2021
    1. Page MJ, Higgins JPT, Sterne JAC. Chapter 13: Assessing risk of bias due to missing results in a synthesis. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from .
Pitkin 1999
    1. Pitkin RM, Branagan MA, Burmeister LF. Accuracy of data in abstracts of published research articles. JAMA 1999;281(12):1110-1.
RevMan 2020 [Computer program]
    1. Review Manager 5 (RevMan 5). Version 5.4. Nordic Cochrane Centre, The Cochrane Collaboration, 2020.
Savino 2013
    1. Savino F, Ceratto S, Opramolla A, Locatelli E, Tarasco V, Amaretti A, et al. Coliforms and infant colic: fish analysis of fecal samples of breast fed and formula fed infants. Journal of Pediatric Gastroenterology and Nutrition 2013;56:472.
Schünemann 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A (editors). Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach. Updated October 2013.
Schurman 2010
    1. Schurman JV, Hunter HL, Friesen CA. Conceptualization and treatment of chronic abdominal pain in pediatric gastroenterology practice. Journal of Pediatric Gastroenterology and Nutrition 2010;50(1):32-7.
van Tilburg 2013
    1. Tilburg MA, Felix CT. Diet and functional abdominal pain in children and adolescents. Journal of Pediatric Gastroenterology and Nutrition 2013;57(2):141-8.
Varni 2015
    1. Varni JW, Shulman RJ, Self MM, Nurko S, Saps M, Saeed SA, et al. Symptom profiles in patients with irritable bowel syndrome or functional abdominal pain compared with healthy controls. Journal of Pediatric Gastroenterology and Nutrition 2015;61(3):323-9.
Waller 2011
    1. Waller PA, Gopal PK, Leyer GJ, Ouwehand AC, Reifer C, Stewart ME, et al. Dose-response effect of Bifidobacterium lactis HN019 on whole gut transit time and functional gastrointestinal symptoms in adults. Scandinavian Journal of Gastroenterology 2011;46(9):1057-64.

Source: PubMed

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