Management of chronic pain in children and young people: summary

8. Dietary Therapies

Much of the work in this area has focussed on abdominal pain. Each systematic review noted that their conclusions are based upon a small number of studies [51, 86]. There is overlap between reviews on the use of fibre in functional gastro-intestinal disorders however the findings and conclusions are consistent.

The evidence suggests that dietary fibre does not influence pain in children with functional gastrointestinal disorders [86]. A good quality systematic review supported a positive effect for probiotics in treating irritable bowel syndrome [51] as a significant reduction in abdominal pain was found in the VSL#3 group (1.0 ± 0.2 versus 0.5 ± 0.2 in control participants).
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Clinicians should consider the use of probiotics Lactobacillus rhamnosus GG ( LGG) and VSL#3 in treatment of children and young people with functional gastro-intestinal disorders – especially if symptoms are severe. Probiotics are not available as a prescription medication so they must be obtained from health food stores or supermarkets etc., and are not subject to the same regulation as prescribed medications.

Recommendations

• The use of probiotics ( LGG and VSL#3) should be considered in children and young people with functional gastro-intestinal disorders.