Synbiotics in the Management of Pediatric Gastrointestinal Disorders: Position Paper of the ESPGHAN Special Interest Group on Gut Microbiota and Modifications.

Iva Hojsak, Sanja Kolaček, Walter Mihatsch, Alexis Mosca, Raanan Shamir, Hania Szajewska, Yvan Vandenplas

Journal: Journal of pediatric gastroenterology and nutrition 2022;76(1):102-108

PMID: 35900172

Abstract

BACKGROUND

Synbiotics are a mixture comprising of live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host. There is an increasing number of studies investigating their role in different diseases and disorders.

AIM

The purpose of this article is to provide recommendations for the use of synbiotics in the management of pediatric gastrointestinal disorders. The recommendations are developed by the ESPGHAN Special Interest Group on Gut Microbiota and Modifications.

METHODS

From existing literature databases, we searched and appraised all systematic reviews and/or meta-analyses, and subsequently published randomized controlled trials (RCTs) that compared the use of synbiotics, in all delivery vehicles and formulations, at any dose, compared to no synbiotics. Synbiotics which are part of infant formula were not assessed. The recommendations were formulated only if at least 2 RCTs that used a well-defined synbiotic were available.

RESULTS

Based on the currently available evidence, no recommendation can be formulated in favor or against the use of evaluated synbiotic combination in the treatment of acute gastroenteritis, prevention of necrotizing enterocolitis, Helicobacter pylori infection, inflammatory bowel disease, functional gastrointestinal disorders, and allergy in infants and children.

CONCLUSIONS

There is a need for more, well-designed RCTs on the role of synbiotics in gastrointestinal disorders with the same outcome measures to enable the inter-studies comparisons.

Copyright © 2022 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Address: From the Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.; the Department of Pediatrics Ulm University, Ulm, and Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany.; the Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France.; the Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's, Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; the Department of Paediatrics, The Medical University of Warsaw, Warsaw, Poland.; the Vrije Universiteit Brussel (VUB), UZ Brussel, Kidz Health Castle, Brussels, Belgium.; Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Emma Children's Hospital, Paediatrics-Neonatology.; Department of Translational Medical Sciences, Section of Paediatrics, University of Naples Federico II.; Department of Pediatrics, "F. Del Ponte" Hospital, University of Insubria.; Department of Clinical Sciences, Paediatrics, Umea University.; Centro de Investigacion Translacional en Ciencias de la Salud, Hospital General Dr. Manuel Gea Gonzalez, Ciudad de Mexico, (CDMX).; Department of Medical and Surgical Science Pediatric Section, University of Foggia.; Department of Gastroenterology, Hepatology and Nutrition, University Medical Centre Ljubljana, University Children's Hospital Ljubljana.; Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel.

DOI: 10.1097/MPG.0000000000003568

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MeSH Terms: Infant, Humans, Child, Infant, Newborn, Probiotics, Gastrointestinal Microbiome, Public Opinion, Synbiotics, Inflammatory Bowel Diseases