A Randomized Controlled Trial of <i>Lactobacillus</i> GG in Children With Functional Abdominal Pain

Francavilla, Ruggiero; Miniello, Vito Leonardo; Magistà, Anna Maria; Canio, A. De; Bucci, N.; Gagliardi, F.; Lionetti, Elena; Castellaneta, Stefania; Polimeno, Lorenzo; Peccarisi, Lucia; Indrio, Flavia; Cavallo, Luciano

doi:10.1542/peds.2010-0467

Cited by 204 publications

(160 citation statements)

References 39 publications

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“…25,31,32,38,42,44,47,49,50 Four studies assessed quality of life, 25,28,29,44 and 8 studies assessed adverse effects. 24,25,37,38,[41][42][43][44] Data of 3 studies were pooled to perform a meta-analysis of the efficacy of fiber supplements, [36][37][38] and 3 studies were used to perform a meta-analysis on probiotics. [41][42][43] Table 1 presents the characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…73 RCTs in children and adolescents evaluating LGG and VSL#3 in FAP, IBS, and functional dyspepsia indicate beneficial effects over placebo, but probiotics seem mostly effective in IBS. 27,[41][42][43] Probiotics also seem effective in adults with AP-FGIDs, but future research must clarify which probiotic strains are most effective. 74 Although .40% of children with IBS and FAP use complementary and alternative medicine, 75 data are lacking on the efficacy and safety of almost all forms of this treatment in children and adolescents.…”

Section: Alternative Medicinementioning

confidence: 99%

“…Placebo responses in trials of adults with IBS vary from 16.0% to 71.4%, 78 and high placebo rates up to 53% were reported in RCTs on children and adolescents. 41,43,79 High placebo responses may also display natural course of FGIDs with fluctuating symptoms. 80 Because symptoms may resolve without active treatment in a significant proportion of children, the first step in management may consist of physician reassurance and education.…”

Section: Alternative Medicinementioning

confidence: 99%

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Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

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BACKGROUND AND OBJECTIVE: Various nonpharmacologic treatments are available for pediatric abdominal pain-related functional gastrointestinal disorders (AP-FGIDs). Data on efficacy and safety are scarce. The goal of this study was to summarize the evidence regarding nonpharmacologic interventions for pediatric AP-FGIDs: lifestyle interventions, dietary interventions, behavioral interventions, prebiotics and probiotics, and alternative medicine.METHODS: Searches were conducted of the Medline and Cochrane Library databases. Systematic reviews and randomized controlled trials (RCTs) concerning nonpharmacologic therapies in children (aged 3-18 years) with AP-FGIDs were included, and data were extracted on participants, interventions, and outcomes. The quality of evidence was assessed by using the GRADE approach.RESULTS: Twenty-four RCTs were found that included 1390 children. Significant improvement of abdominal pain was reported after hypnotherapy compared with standard care/wait-list approaches and after cognitive behavioral therapy compared with a variety of control treatments/wait-list approaches. Written self-disclosure improved pain frequency at the 6-month follow-up only. Compared with placebo, Lactobacillus rhamnosus GG (LGG) and VSL#3 were associated with significantly more treatment responders (LGG relative risk: 1.31 [95% confidence interval: 1.08 to 1.59]; VSL#3: P , .05). Guar gum significantly improved irritable bowel syndrome symptom frequency; however, no effect was found for other fiber supplements (relative risk: 1.17 [95% confidence interval: 0.75 to 1.81]) or a lactose-free diet. Functional disability was not significantly decreased after yoga compared with a wait-list approach. No studies were found concerning lifestyle interventions; gluten-, histamine-, or carbonic acid-free diets; fluid intake; or prebiotics. No serious adverse effects were reported. The quality of evidence was found to be very low to moderate. CONCLUSIONS:Although high-quality studies are lacking, some evidence shows efficacy of hypnotherapy, cognitive behavioral therapy, and probiotics (LGG and VSL#3) in pediatric AP-FGIDs. Data on fiber supplements are inconclusive.

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Section: Resultsmentioning

confidence: 99%

Section: Alternative Medicinementioning

confidence: 99%

Section: Alternative Medicinementioning

confidence: 99%

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Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

et al. 2015

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“…[14][15][16] One trial assessed the effect of Lactobacillus rhamnosus GG (LGG) in pediatric patients with FAPD [FD, irritable bowel syndrome (IBS) and functional abdominal pain (FAP)] who were given LGG 3 x 10 9 CFU, twice daily for 4 weeks. The LGG appeared to moderately increase treatment success, particularly among children with IBS.…”

Section: Discussionmentioning

confidence: 99%

Lactobacillus probiotics for treating functional dyspepsia in children

Ahyani

Supriatmo

Deliana

et al. 2016

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“…There have been twenty-eight controlled trials assessing the efficacy of probiotics in adults suffering from IBS with twenty (71 %) showing a positive effect (43,(57)(58)(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75) , seven showing no effect (43,(76)(77)(78)(79)(80)(81) and one leading to a deterioration of symptoms (82) . In addition, four trials in children all gave positive results (83)(84)(85)(86) . However, the quality of some of these trials has not been optimal and there is always the problem of the possibility of publication bias.…”

Section: Treating Irritable Bowel Syndrome With Probioticsmentioning

confidence: 94%

Irritable bowel syndrome: the problem and the problem of treating it – is there a role for probiotics?

Santos¹,

Whorwell²

2014

Proc. Nutr. Soc.

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The aim of this review is to highlight the impact of irritable bowel syndrome (IBS) in those patients who consult the medical profession and examine the therapeutic potential of probiotics in this condition, where there is a strong need for new treatment options. Traditionally, IBS is frequently regarded as a trivial condition which is certainly not life threatening and mainly psychological in origin. However, these preconceptions are misplaced, as in some patients the condition can be devastating with the pain being as severe as that of childbirth coupled with incapacitating bowel dysfunction. In addition, patients suffer from a variety of non-colonic symptoms such as low backache, constant lethargy, nausea and genito-urinary problems, all of which lead to these patients having extremely poor quality of life. Unfortunately, the treatment of IBS is very unsatisfactory with only one new medication being developed for this condition in the last 25 years. It is now recognised that IBS is a multifactorial condition with symptoms being triggered by a variety of factors, some of which appear to be influenced by probiotics, resulting in speculation that they may have therapeutic potential in this condition. There have been over thirty controlled clinical trials of probiotics in IBS with approximately two-thirds of these studies showing evidence of an improvement in symptoms. However, not all probiotics appear to be effective with different symptoms being improved by different strains and some improving symptoms more than others. Consequently, the ideal probiotic for the treatment of IBS has yet to be defined, but the evidence is good enough to encourage further research with the aim of identifying an optimal strain or strains.

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A Randomized Controlled Trial of Lactobacillus GG in Children With Functional Abdominal Pain

Abstract: LGG significantly reduces the frequency and severity of abdominal pain in children with IBS; this effect is sustained and may be secondary to improvement of the gut barrier.

Cited by 204 publications

References 39 publications

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Lactobacillus probiotics for treating functional dyspepsia in children

Irritable bowel syndrome: the problem and the problem of treating it – is there a role for probiotics?

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