VSL#3 Improves Symptoms in Children With Irritable Bowel Syndrome: A Multicenter, Randomized, Placebo‐Controlled, Double‐Blind, Crossover Study

Guandalini, Stefano; Magazzù, Giuseppe; Chiaro, Andrea; Balestra, Valeria; Nardo, Giovanni Di; Gopalan, Sarath; Sibal, Anupam; Romano, Claudio; Canani, Roberto Berni; Lionetti, Paolo; Setty, Mala

doi:10.1097/mpg.0b013e3181ca4d95

Cited by 241 publications

(169 citation statements)

References 32 publications

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“…Thirteen articles remained for analysis: 7 systematic reviews 11,12,15,16,18,22,23 (including 18 RCTs) and 6 RCTs. [24][25][26][27][28][29] Two included trials concerned follow-up studies, 26,30 which will be discussed by using their original studies. 31,32 Two systematic reviews 11,12 included studies with ,10 patients per treatment arm, and these studies were therefore excluded.…”

Section: Resultsmentioning

confidence: 99%

“…40,41 The method of randomization was unclear in 3 studies. 27,31,50 Alfvén and Lindstrom 48 provided no information on outcome blinding or treatment duration. Six trials did not present results with absolute numbers and were therefore not included in the meta-analysis.…”

Section: Methodologic Qualitymentioning

confidence: 99%

“…Six trials did not present results with absolute numbers and were therefore not included in the meta-analysis. 27,39,40,44,47,48 Analyses for follow-up were uncontrolled for baseline differences by Levy et al 31 Because participants were recruited through physician referral and flyers, these patients were therefore seriously motivated, which can cause bias.…”

Section: Methodologic Qualitymentioning

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%

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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: Methodologic Qualitymentioning

confidence: 99%

Section: Methodologic Qualitymentioning

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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“…In this study total of 59 children were evaluated and abdominal pain, abdominal bloating/gassiness and family assessment of life disruption were improved significantly. 31 In a randomized study involving 78 children (total of 345 children aged 4-18 years) with IBS, there was seen clinical recovery 94.9% of 39 children treated with trimebutine maleate. Authors concluded that trimebutine maleate is an effective agent for treating childhood IBS.…”

Section: Treatmentmentioning

confidence: 99%

Irritable Bowel Syndrome in Childhood: Review

Gökçe¹,

Karakoyun²,

Yağcı³

et al. 2015

Turkiye Klinikleri J Pediatr

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A AB BS S T TR RA AC CT T Irritable bowel syndrome (IBS), is also known spastic colon, is one of the functional bowel diseases. Etiology of IBS is unknown and is associated with symptoms such as diarrhea and constipation. It usually affects both adults and adolescents. Functional bowel differences, disordered defecation habits and chronic abdominal pain, which is the most common of the symptoms, is due to bowel disorder. The frequency of the pain varies from patient to patient and is usually observed on the around umblicus but the pain observed another places on the abdomen. Etiopathogenesis hasn't become definite yet. The second important symptom is disturbed defecation and the changes in defecation pattern. Constipation and diarrhea often follow each other. Patients need to defecate after each meal. Dyspeptic symptoms; especially postprandial abdominal tenderness, abdominal discomfort, bloating, gas, indigestion, loss of appetite, nausea are also common in IBS. Diagnostic criteria which named Rome III criteria based on recurrent abdominal pain or discomfort following; improvement with defecation or change in frequency of stool or stool appearance. We report here; irritable bowel syndrome, diagnosis and treatment of it in children. K Ke ey y W Wo or rd ds s: : Child; irritable bowel syndrome Ö ÖZ ZE ET T İrritabl barsak sendromu (İBS) spastik kolon olarak da bilinen; fonksiyonel barsak hastalık-larından biridir. Etiyolojisi tam kesinleşmemiştir ve daha çok konstipasyon ve ishal gibi semptomlar ile karakterize bir hastalıktır. Genelde adolesan ve erişkinleri etkilemektedir. Organik bir neden olmaksızın barsaklarda fonksiyon değişiklikleri-dışkılama düzenindeki değişiklikler ve kronik karın ağrısı başlıca semptomlardır. Karın ağrısı; şiddeti, sıklığı hastadan hastaya değişiklik gösteren ve emosyonel stres, soğuk, bazı yiyecekler, bazı ilaçlarla şiddeti artan özelliktedir. Karın ağrısı genellikle göbek çevresinde olmakla birlikte birçok hastada farklı yerlerde de olabilmektedir. Etiyolojisi henüz netleştirilememiştir. Karın ağrısı dışında dışkılama rahatsızlıkları ve dışkılama düzenindeki değişiklikler ikinci önemli semptomdur. Çoğu kez konstipasyon ve ishal hali birbirini izler. Hastalar her yemekten sonra defekasyon ihtiyacı duyarlar. Dispeptik yakınmalar; özellikle postprandial karın gerginliği, karın rahatsızlığı, karın şişliği, gaz, hazımsızlık, geğirme, iştahsızlık, bulantı da İBS'de sık görülen yakınmalardır. Tanısında detaylı anamnez ve fizik bakı önemlidir. Uzun süredir devam eden karın ağrısı, ishal, konstipasyon dönemlerinin birbirini takip etmesi, hasta görünümün olmaması tanıda önemlidir. Son yirmi yıl içinde İBS tanısında kolaylık sağlayan bazı kriterler ortaya sürülmüştür. Karın ağrısı ya da karında rahatsızlık hissi ile bu duruma eşlik eden dışkılama düzenindeki değişiklikler ve dışkının görünüm değişiklikleri IBS tanısında Rome III kriterleri olarak kullanılmaktadır. Bu derlemede İBS'nin çocuklarda semptomları, tanısal yöntemleri ve tedavi yaklaşımları anlatılmaktadır.

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Dietary interventions for recurrent abdominal pain in childhood

Newlove‐Delgado

Martin

Abbott

et al. 2017

Cochrane Database of Systematic Reviews

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Overall, we found moderate- to low-quality evidence suggesting that probiotics may be effective in improving pain in children with RAP. Clinicians may therefore consider probiotic interventions as part of a holistic management strategy. However, further trials are needed to examine longer-term outcomes and to improve confidence in estimating the size of the effect, as well as to determine the optimal strain and dosage. Future research should also explore the effectiveness of probiotics in children with different symptom profiles, such as those with irritable bowel syndrome.We found only a small number of trials of fibre-based interventions, with overall low-quality evidence for the outcomes. There was therefore no convincing evidence that fibre-based interventions improve pain in children with RAP. Further high-quality RCTs of fibre supplements involving larger numbers of participants are required. Future trials of low FODMAP diets and other dietary interventions are also required to facilitate evidence-based recommendations.

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VSL#3 Improves Symptoms in Children With Irritable Bowel Syndrome: A Multicenter, Randomized, Placebo‐Controlled, Double‐Blind, Crossover Study

Abstract: : VSL#3 is safe and more effective than placebo in ameliorating symptoms and improving the quality of life in children affected by IBS.

Cited by 241 publications

References 32 publications

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Nonpharmacologic Treatment of Functional Abdominal Pain Disorders: A Systematic Review

Irritable Bowel Syndrome in Childhood: Review

Dietary interventions for recurrent abdominal pain in childhood

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