Limosilactobacillus reuteri DSM 17938 in pediatric functional abdominal pain disorders and functional constipation: A systematic review and meta‐analysis of randomized controlled trials
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Pooling five RCTs in children with functional abdominal pain and five in functional constipation, L. reuteri DSM 17938 did not significantly improve responder rates, pain, or stool frequency versus placebo. Larger strain-specific trials were called for.
OBJECTIVES: Functional abdominal pain (FAP) and functional constipation (FC), are common in children and affect quality of life. Dysfunction of the microbiota-gut-brain axis may contribute to their pathophysiology, with growing interest in probiotic interventions. Limosilactobacillus reuteri (L. reuteri) DSM 17938 has been widely studied, but its efficacy remains unclear. This systematic review and meta-analysis aimed to evaluate the efficacy of L. reuteri DSM 17938 in pediatric FAP and FC. METHODS: Randomized controlled trials (RCTs) published up to October 2025 were identified from major databases. Eligible studies included children diagnosed by Rome criteria and treated with L. reuteri DSM 17938 as a single strain. Primary outcomes were responder rates for FAP and normalization of stool frequency for FC, with abdominal pain frequency and intensity assessed as secondary outcomes for FAP. RESULTS: Five RCTs, including 302 children with FAP, and five RCTs, including 276 children with FC, were analyzed. In FAP, L. reuteri DSM 17938 did not significantly improve responder rates (risk ratio [RR] 1.11, 95% confidence interval [CI] 0.83-1.47, p = 0.49), abdominal pain frequency (p = 0.91; 95% CI -0.42 to 0.38), or pain intensity (p = 0.14, 95% CI -1.07 to 0.15) compared with placebo in meta-analysis. In FC, the pooled analysis showed no significant difference in stool frequency (RR 1.1, 95% CI 0.94-1.27, p = 0.27). CONCLUSIONS: In this systematic review and meta-analysis, L. reuteri DSM 17938 did not demonstrate clinically significant benefits in pediatric FAP or FC. Further well-powered, strain-specific RCTs with standardized outcome measures are warranted to clarify its role.
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