Effectiveness of Probiotics in Children With Functional Abdominal Pain Disorders and Functional Constipation

Abstract

Insufficient evidence exists for the use of probiotics in FAPD and FC, only L. rhamnosus GG seems to reduce frequency and intensity of abdominal pain but only in children with irritable bowel syndrome. A better understanding of differences in gut microbiota in health and disease might lead to better probiotic strategies to treat disease.

Paediatric functional abdominal pain disorders

“…These investigations suggest that particular combinations of probiotics or specific species might be effective but their role remains unclear owing to study limitations such as sample size, blinding, differences in the probiotics used and the different dosing 157 . Although meta-analyses of paediatric trials have been performed, only few studies exist and with similar caveats to the adult meta-analyses 158,159 . Among five RCTs investigating children with FAP-NOS, the probiotic Lactobacillus reuteri DSM 1793 improved abdominal pain in three studies [160][161][162] , reduced functional disability but not abdominal pain in one study 163 , and was not superior to placebo in another 164 , although the methods of pain evaluation were different across studies.…”

Curative Treatment of Candidiasis by the Live Biotherapeutic Microorganism Lactobacillus rhamnosus Lcr35® in the Invertebrate Model Caenorhabditis elegans: First Mechanistic Insights

“…Beyond the antipathogenic properties of Lcr35 ® , recent studies in humans have shown improvement in the health of patients with the administration of LBM. The effectiveness of Lcr35 ® for the treatment of abdominal pain and intestinal functional disorders has been demonstrated in children [22][23][24] without however highlighting the molecular mechanisms. Recently, Dausset and colleagues demonstrated in women the safety and well-tolerated characteristics of a new galenic form based on Lcr35 ® , promoting the growth of endogenous vaginal Lactobacillus, in order to prevent an eventual dysbiosis [25].…”

Functional abdominal pain: what clinicians need to know

“…Other studies have assessed differing strains of L. reuteri and found significant improvement 41 42. However, a recent systematic review could not find a significant clinical effect of probiotics in children with FAP 15…”

“…Visceral hypersensitivity is increased in both inflammation and states of psychological stress13; there is limited evidence that the degree of visceral hypersensitivity is related to symptom severity 14. Visceral hypersensitivity is felt to play a significant role in the aetiology of FAP, and its reduction, by alleviating triggers, is felt to be a potential contributor to treatment success with therapies such as probiotics 15…”

“…There has been a rise in interest in the gut microbiota, including its role in FAP 39. The mechanism of the effect of probiotics on FAP is poorly understood and evidence for their use is limited 15. Hypotheses include the abnormal microbiota activating the mucosal innate immune responses, increasing epithelial permeability and dysregulating the enteric nervous system 39.…”