Probiotics for pediatric diarrhea and constipation: an umbrella meta-analysis

The current evidence regarding the impact of probiotics on diarrhea and constipation outcomes in children is inconclusive. This umbrella review of systematic reviews and meta-analyses aims to deliver a comprehensive and conclusive summary of the effectiveness of probiotics in managing these conditions in pediatric populations.

Meta-analyses were collected from Scopus, PubMed, Embase, and the Web of Science until May 2025. The overall effect size was calculated using a random effect model.

This umbrella study comprises a systematic review of 35 studies. Our findings illustrated that probiotics reduce diarrhea incidence (ES = 0.52; 95% CI: 0.40, 0.68, P < 0.001; I2 = 91.2%, p < 0.001) compared to the control group, meaningfully. Also, it is successful in reducing diarrhea duration (WMD = -1.85; 95% CI: -2.83, -0.86, P < 0.001; I² = 94.7%, p- <0.001; SMD = -0.94; 95% CI: -1.32, -0.56, P < 0.001; I² = 88.4%, p- <0.001) significantly. Probiotics had no significant effect on stool frequency (WMD = 0.22; 95% CI: -0.30, 0.74, P = 0.414, I² = 82.7%, P = 0.003; SMD= -0.22; 95% CI: -1.25, 0.81, P = 0.674). Probiotics prevent diarrhea by about 53% (ES = 0.47; 95% CI: 0.32, 0.71, P < 0.001).

This meta-analyses highlights the potential benefits of probiotics in improving diarrhea outcomes in children, demonstrating a reduction in both the incidence and duration of diarrhea following probiotic supplementation.