Efficacy and Safety of Probiotics in Children with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction (DGBI), whose exact etiology remains unclear. The "brain-gut-microbiota axis" proved to be a key target in IBS management and there is strong evidence supporting the use of probiotics for improving overall symptoms both in adults and in children. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the effects of probiotic supplementation in pediatric patients diagnosed with IBS according to Rome III or IV criteria. Scopus, PubMed, and Cochrane Library were the available databases systematically searched up to February 2025. Six RCTs with 604 participants were included in the final systematic review. Three RCTs provided data from which the meta-analysis demonstrated that probiotic supplementation has a significant effect on reducing abdominal pain in patients with IBS (SMD -0.95, 95% CI -1.63 to -0.27). Other three RCTs reported data on the effects on stool consistency, and their meta-analysis proved that supplementation results in stool consistency normalization in patients with diarrhea or constipation (OR 2.17, 95% CI 1.18 to 4). The present meta-analysis demonstrated that probiotic supplementation can reduce abdominal pain in pediatric patients with IBS and provide significant bowel habit normalization in patients with diarrhea or constipation at baseline compared to placebo.