Probiotic Therapy for Abdominal Symptoms? Which One?
Abdominal pain is one of the most common complaints among children, but more often than not, the cause of the pain is not limited to the abdomen. Like adults with irritable bowel syndrome (IBS), kids have a similar category, historically known as Functional Abdominal Pain, now referred to as Disorders of Gut-Brain Interaction (DGBIs).
The brain and the gut have a communication system, and many factors— such as anatomic, behavioral, environmental, neural, and microbiotic determinants—influence that communication. As a result, children (and adults) with symptoms of anxiety, OCD, or depression often present with stomach complaints that can not be seen or diagnosed with imaging or scoping. This can be difficult for parents and children to comprehend, and unfortunately sometimes families are dismissively told the pain is “in the child’s head,” left without concrete solutions to mitigating the very real pain being experienced.
While treatments for DGBIs vary from pharmacologic options to hypnotic therapy to percutaneous vagal nerve stimulation, a recent systematic review and meta-analysis highlighted the important role of probiotics. By directly altering the gut lining, interacting with ingested foods, or releasing metabolites that signal immune and neurologic activity, the microbiome is inextricably intertwined with DGBIs. Here, the emergence of psychobiotics has tried to stabilize this complex relationship of the gut-brain axis, specifically for their role in intestinal inflammation and neuromodulation. Based on this study and the gastroenterology guidelines for treating DGBIs, here are the facts all parents should know about probiotics:
There is no one-strain-fits-all solution, but there are some strains that have been better studied than others.
For children, the best data is Lactobacillus reuteri DSM 17938 (now Limosilactobacillus reuteri) and Lactobacillus rhamnosus GG / LGG (now Lacticaseibacillus rhamnosus GG). These can be found in chewable products like BioGaia and Culturelle. For teens and adults, data supports the Bifidobacter strain found in Align (—please note: I have not been paid for these endorsements and declare no conflicts of interest by the related industry).
Buy a probiotic that is either third party verified or has research to back its claims.
Like so many supplements out there, what is written on the label may not reflect what is in the bottle. This is especially important with probiotics since they are usually effective when alive, and processing and shelf life may render the strains ineffective. I find this sometimes difficult—especially since the brands I recommended above are not third party tested—and you have to look for other evidence of purity, like product-specific research, good manufacturing practices, and quality control measures. In the case of the products I recommended, they have been studied in multiple peer-reviewed trials.
Give probiotic regimens a 4-8 week trial.
If after this time period you are not feeling any benefits, I would not continue treatment. Probiotics are expensive, and in most studies, even when effective, they may offer symptom improvements in 30 or 40% of cases.
Treatment for DGBIs is multifaceted.
Probiotics alone will not do the trick. Treatment often encompasses a multidisciplinary healthcare team, dietary modifications, cognitive behavioral therapy, neuromodulation medications, education, peppermint oil, probiotics, prebiotics, or even a percutaneous neurostimulation device. Consult your healthcare team or GI physician for a confirmatory diagnosis, if having more serious symptoms, or if you find your quality of life is being severely impacted.
The Breakdown
Stomach complaints are common and often due to a Disorder of Gut-Brain Interaction, which remain relatively misunderstood and understudied. These issues are also more widespread than you may think; research suggests that 4 out of 10 adults in the U.S. have a form of DGBI. These disorders respond to various therapeutic interventions, including probiotic supplements. While every human gut has a unique fingerprint, there are some research-backed strains that may warrant a 4-8 week trial. Discuss with your health team if you think probiotics may help your condition.
You may also enjoy learning more about fiber intake to help with abdominal symptoms or changing positions to relieve constipation.
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For more perspective on what it takes to have and raise a thriving little human, check out my podcast, The Unplanned Parent, on Apple, Spotify, YouTube, or wherever you listen or watch.
References:
Balasan, Nour et al. “Probiotics in pediatric functional abdominal pain disorders: a systematic review and meta-analysis.” European journal of pediatrics vol. 185,8 592. 20 Jul. 2026, doi:10.1007/s00431-026-07161-5
Groen, Jip et al. “ESPGHAN/NASPGHAN guidelines for treatment of irritable bowel syndrome and functional abdominal pain-not otherwise specified in children aged 4-18 years.” Journal of pediatric gastroenterology and nutrition vol. 81,2 (2025): 442-471. doi:10.1002/jpn3.70070
Palsson OS, Sperber AD, Bangdiwala S, Whitehead WE. Prevalence and associated factors of disorders of gut-brain interaction in the United States: Comparison of two nationwide Internet surveys. Neurogastroenterol Motil. 2023 Jun;35(6):e14564. doi: 10.1111/nmo.14564. Epub 2023 Mar 24. PMID: 36961084.