Irritable bowel syndrome (IBS), as described by the Rome criteria, includes abdominal pain (AP) or discomfort associated with changes in bowel patterns.
Despite a still incomplete pathophysiologic understanding of this condition, IBS is generally considered a disorder of the brain-gut axis. This bidirectional connection between the central and the enteric nervous systems links emotional and cognitive centers of the brain with intestinal motility and entero-endocrine and immune functions, likely determining the clinical expression of most functional gastrointestinal disorders (FGIDs).
Probiotics are emerging as new therapeutic tools in FGIDs, due to the recognition of the importance of gut microbiota in influencing brain-gut interactions, and of the role played by intestinal infections in the genesis of AP-FGIDs. Preclinical data suggest that changes in the gut microbiota can affect brain signaling systems related to pain and associated emotional behavior. Therefore, probiotics likely play a relevant role in the management of FGIDs, by affecting the gut microbiota or by altering brain function and pain perception centrally.
Few randomized clinical trials (RCTs) are available in children. A meta-analysis including 9 trials which tested different probiotics as a treatment for FGIDs in children and adolescents concluded that Lactobacillus GG, Lactobacillus reuteri DSM 17938 and VSL#3 significantly increased treatment success, particularly in children with associated bowel changes.
We recently showed that, in children with IBS, a mixture of Bifidobacterium infantis M-63®, breve M-16V® and longum BB536® is safe and is associated with better AP control and improved QoL when compared to placebo.
University of Naples “Frederico II”, Naples, Italy