[Do bulk preparations help in cases of recurrent abdominal pain in children? A controlled study]. The use of Lactobacillus GG in irritable bowel syndrome in children: a double-blind randomized control trial. A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children. Dietary lactose and the child with abdominal pain. Recurrent abdominal pain and lactose absorption in children.
nan 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.
                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).
                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).
                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. Functional abdominal pain disorders (FAPD) are common in school-aged children; however, there is no reliable treatment.
                To determine the efficacy of Lactobacillus rhamnosus GG (LGG) for treating FAPD in children.
                A total of 104 children who fulfilled the Rome II criteria for functional dyspepsia (FD), or irritable bowel syndrome (IBS), or functional abdominal pain (FAP) were enrolled in a double-blind, randomized controlled trial in which they received LGG (n = 52), or placebo (n = 52) for 4 weeks.
                For the overall study population, those in the LGG group were more likely to have treatment success (no pain) than those in the placebo group (25% vs. 9.6%, relative benefit (RB) 2.6, 95% confidence interval (CI): 1.05-6.6, number needed to treat (NNT) 7, 95% CI: 4-123). For children with IBS (n = 37), those in the LGG group were more likely to have treatment success than those in the placebo group (33% vs. 5%, RB 6.3, 95% CI: 1.2-38, NNT 4, 95% CI: 2-36) and reduced frequency of pain (P = 0.02), but not pain severity (P = 0.10). For the FD group (n = 20) and FAP group (n = 47), no differences were found.
                The LGG appears to moderately increase treatment success, particularly among children with IBS. nan The association of lactase deficiency with recurrent abdominal pain was investigated. One hundred three white children between the ages of 6 to 14 years with recurrent abdominal pain were evaluated. Sixty-nine underwent lactose tolerance tests and 26 had intestinal biopsies with lactase determinations; 21 of 69 (30.4%) had abnormal lactose tolerance tests and eight of 26 (31%) were lactase deficient. However, 16 of 61 (26.4%) control subjects matched for age and ethnic background exhibited lactase deficiency. Thus, a similar prevalence of lactase deficiency was found in the control and the recurrent abdominal pain groups. Thirty-eight patients with recurrent abdominal pain completed three successive six-week diet trials conducted in a double-blind fashion. An increase above base line value in pain frequency was seen in ten of 21 (48%) lactose malabsorbers and four of 17 (24%) lactose absorbers. After a 12-month milk elimination diet, six of 15 (40%) malabsorbers and five of 13 (38%) absorbers had elimination of their pain. This result compared with improvement occurring in five of 12 (42%) absorbers with recurrent abdominal pain who received a regular diet for one year and suggests that the elimination of lactose will not affect the overall frequency of improvement in recurrent abdominal pain. In addition, the recovery rate from recurrent abdominal pain is similar in both lactose absorbers and nonabsorbers independent of dietary restrictions.
There is a lack of high quality evidence on the effectiveness of dietary interventions. This review provides no evidence that fibre supplements, lactose free diets or lactobacillus supplementation are effective in the management of children with RAP.