Original Article
The Use of Lactobacillus GG in Irritable Bowel Syndrome in Children: A Double-blind Randomized Control Trial

https://doi.org/10.1016/j.jpeds.2005.05.015Get rights and content

Objective

To determine whether oral administration of the probiotic Lactobacillus GG under randomized, double-blinded, placebo-controlled conditions would improve symptoms of irritable bowel syndrome (IBS) in children.

Study design

Fifty children fulfilling the Rome II criteria for IBS were given Lactobacillus GG or placebo for 6 weeks. Response to therapy was recorded and collected on a weekly basis using the Gastrointestinal Symptom Rating Scale (GSRS).

Results

Lactobacillus GG was not superior to placebo in relieving abdominal pain (40.0% response rate in the placebo group vs 44.0% in the Lactobacillus GG group; P = .774). There was no difference in the other gastrointestinal symptoms, except for a lower incidence of perceived abdominal distention (P = .02 favoring Lactobacillus GG).

Conclusions

Lactobacillus GG was not superior to placebo in the treatment of abdominal pain in children with IBS but may help relieve such symptoms as perceived abdominal distention.

Section snippets

Methods

Sixty-four children (12 male and 52 female) were enrolled in this controlled, double-blind, randomized study from the Children's Medical Center Pediatric Gastroenterology outpatient clinic between July 2003 and June 2004 (Figure). Mean patient age was 12 years, with a range of 6 to 20 years. All children had a previous evaluation by a pediatric gastroenterologist, who made the diagnosis of IBS and excluded organic disease as a cause of abdominal pain. Testing for organic disease was performed

Results

Six patients withdrew from the study after randomization before beginning treatment (Figure). Reasons given for discontinuation included lack of time for daily record keeping, preference for other therapy, and desire not to participate. Twenty-eight patients were randomized into the placebo group and began treatment. Three of these patients were lost to follow-up. Of the 30 patients in the Lactobacillus GG group, 3 patients were lost to follow-up. Two children were excluded from the analysis

Discussion

The etiology of IBS remains largely unknown, and the range of symptoms associated with this syndrome seems to indicate a multitude of etiologic influences, including psychosocial factors, altered GI motility, heightened sensory function of the intestine, and malfermentation of food residues.15 Insults to the intestinal microflora have been implicated in the pathogenesis of IBS. Antibiotic use is the most likely cause of disruption of normal microflora,16 and studies have linked antibiotic use

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Supported by a Wright State University School of Medicine seed grant.

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