Probiotics, prebiotics, and dietary fiber in the management of functional gastrointestinal disorders

At best, currently available therapies provide symptomatic relief from functional gastrointestinal disorders (FGD). No existing therapy, however, can influence the natural course of any of these disorders, prompting interest in new and safe treatment options. This paper summarizes the clinical evidence from randomized controlled trials (RCTs) and their meta-analyses of the effectiveness of probiotics, prebiotics, and dietary fiber in the treatment of FGD in the pediatric population. While it is too soon to recommend the routine use of any probiotics for treating FGD, some of these therapeutic options can provide a health benefit to patients, and therefore can be discussed with patients and/or caregivers. Lactobacillus reuteri DSM 17938 has consistently improved symptoms of infantile colic. The use of Lactobacillus GG moderately increased treatment success in children with abdominal pain-related FGD, particularly among children with irritable bowel syndrome. Also, data from one trial suggest that VSL#3 seems to be effective in ameliorating symptoms and improving the quality of life of children affected by irritable bowel syndrome. L. reuteri DSM 17938 may help infants with constipation. Limited evidence suggests that administration of a fiber supplement is more effective than placebo for the treatment of childhood constipation.