Systematic review and meta-analysis of randomized controlled trials: Lactobacillus rhamnosus GG for abdominal pain-related functional gastrointestinal disorders in childhood

Andrea Horvath (1) , Piotr Dziechciarz (1) , Hania Szajewska (1)

1 Department of Paediatrics

Background: A lack of reliable treatments for abdominal pain-related functional gastrointestinal disorders (FGD) prompts interest in new therapies. Aim: To systematically evaluate the effect of Lactobacillus rhamnosus GG (LGG) for treating abdominal pain-related FGD in children. Methods: MEDLINE, EMBASE, CINAHL, the Cochrane Library, trial registries, and proceedings of major meetings were searched for randomized controlled trials (RCTs) evaluating LGG supplementation in children with abdominal pain-related FGD based on the Rome II or Rome III criteria. Risk of bias was assessed for generation of the allocation sequence, allocation concealment, blinding, and follow-up. Results: Compared with placebo, LGG supplementation was associated with a significantly higher rate of treatment responders (defined as no pain or a decrease in pain intensity) in the overall population with abdominal pain-related FGD (3 RCTs, n=290; relative risk, RR 1.31, 95% CI 1.08 to 1.59, number needed to treat, NNT 7, 95% CI 4 to 22) and in the irritable bowel syndrome (IBS) subgroup (3 RCTs, n=167; RR 1.70, 95% CI 1.27 to 2.27, NNT 4, 95% CI 3 to 8). However, no difference was found in the rate of treatment responders between children with functional abdominal pain or functional dyspepsia who received placebo or LGG. The intensity of pain was significantly reduced in the overall study population and in the IBS subgroup. The frequency of pain was significantly reduced in the IBS subgroup only. Conclusion: The use of LGG moderately increases treatment success in children with abdominal pain-related FGD, particularly among children with IBS.

Mots clés: Medicine

Andrea Horvath, Piotr Dziechciarz, Hania Szajewska. Systematic review and meta-analysis of randomized controlled trials: Lactobacillus rhamnosus GG for abdominal pain-related functional gastrointestinal disorders in childhood. Alimentary Pharmacology and Therapeutics, 2011, 33 (12), pp.1302. ⟨10.1111/j.1365-2036.2011.04665.x⟩. ⟨hal-00633997⟩