The etiology of irritable bowel syndrome (IBS) has not been fully elucidated. Therefore, multi-centered studies examining the efficacy and safety of different probiotics and synbiotics for the treatment of IBS in different age groups are necessary.
Our current study aimed to investigate the efficacy of synbiotics (Bifidobacterium lactis B94, Inulin), probiotics (Bifidobacterium lactis B94) and prebiotics (Inulin) for the treatment of IBS in a pediatric age group. This study was randomized, double-blind, controlled and prospective in design.
This study included 71 children between the ages of 2–18 years old who were diagnosed with IBS according to Roma III diagnostic criteria. The patients were randomly divided into three groups. The first group received synbiotic treatment [5 × 109 colony forming unit (CFU) Bifidobacterium lactis B94 (B. Lactis B94) and 900 mg inulin], the second group received probiotic treatment (5 × 109 CFU B. Lactis B94) and the third group received prebiotic treatment (900 mg inulin). The treatments for each group were administered twice daily in a double-blind setting. All patients were evaluated at the end of a four week treatment period. Those who did not have any complaints at the end of four weeks were considered as having a full recovery. Those who had improvements in one or more of their initial complaints were considered as having improvement of their initial complaints.
At the end of treatment, the prebiotic group had significant improvements in belching-abdominal fullness (p = 0.008), the probiotic group had significant improvements in abdominal fullness (p = 0.016), bloating after meals (p = 0.016) and constipation (p = 0.031), and the synbiotic group had significant improvements in belching-abdominal fullness (p = <0.001), bloating after meals (p = 0.004), constipation (p = 0.021) and mucus in the feces (p = 0.021). The synbiotic group had a significantly higher ratio of full recovery with treatment than did the prebiotic group (39% vs. 12.5%, p = 0.036).
In conclusion, the twice-a-day administration of synbiotics, probiotics and prebiotics is safe for the treatment of children with IBS. When compared to prebiotics, the administration of synbiotics and probiotics provides significant improvements in initial complaints. Furthermore, the ratio of those with full recovery in IBS symptoms was significantly higher in the synbiotic group than in the prebiotic group; the probiotic group was not significantly different.
Akdeniz University Department of Pediatric Gastroenterology, Antalya – Türkiye.