Probiotics for stomach pain

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Probiotics for Stomach Pain: A Comprehensive Review

Introduction to Probiotics and Stomach Pain

Probiotics, live microorganisms that provide health benefits when consumed in adequate amounts, have been increasingly studied for their potential to alleviate stomach pain, particularly in conditions like functional abdominal pain (FAP) and irritable bowel syndrome (IBS). This article synthesizes the latest research on the efficacy of probiotics in managing stomach pain.

Probiotics for Functional Abdominal Pain in Children

Efficacy in Reducing Pain

Several studies have investigated the role of probiotics in managing functional abdominal pain in children. A significant finding is that probiotics can improve pain in children with recurrent abdominal pain. One study found that children treated with probiotics were more likely to experience short-term pain improvement compared to those given a placebo (odds ratio, 1.63; 95% CI, 1.07-2.47). Another comprehensive review of 18 randomized controlled trials (RCTs) involving 1309 children concluded that probiotics might achieve more treatment success compared to placebo, with 50% success in the probiotic group versus 33% in the placebo group (RR 1.57, 95% CI 1.05 to 2.36).

Strain-Specific Effects

The strain-specific effects of probiotics have also been explored. Lactobacillus rhamnosus GG and Lactobacillus reuteri DSM 17938 were found to significantly reduce pain intensity and increase the number of pain-free days in children with functional abdominal pain. However, the evidence remains of low certainty due to high heterogeneity and risk of bias in the studies.

Probiotics for Irritable Bowel Syndrome (IBS)

General Efficacy

Probiotics have shown promise in alleviating symptoms of IBS, including abdominal pain. A systematic review of 19 RCTs involving 1650 patients found that probiotics were significantly better than placebo in improving IBS symptoms, with a relative risk (RR) of IBS not improving at 0.71 (95% CI 0.57 to 0.88). Another meta-analysis of 43 RCTs with 5531 IBS patients identified Bifidobacterium coagulans as the most effective strain for improving IBS symptoms, including abdominal pain, bloating, and straining scores.

Safety and Adverse Events

The safety profile of probiotics in IBS patients has been generally favorable. A meta-analysis of 35 RCTs involving 3452 patients reported that probiotics significantly reduced the persistence of IBS symptoms (RR 0.79, 95% CI 0.70 to 0.89) and improved global symptoms and abdominal pain scores. However, there was a slightly higher incidence of adverse events in patients treated with probiotics compared to placebo (RR 1.21; 95% CI 1.02 to 1.44).

Conclusion

The current body of research suggests that probiotics can be beneficial in managing stomach pain associated with functional abdominal pain and IBS, particularly in children. While certain strains like Lactobacillus rhamnosus GG, Lactobacillus reuteri DSM 17938, and Bifidobacterium coagulans show promise, the evidence is still of low to very low certainty due to high heterogeneity and risk of bias in the studies. Further high-quality, strain-specific research is needed to confirm these findings and establish long-term safety profiles.