Guandalini · Journal of pediatric gastroenterology and nutrition 2010 · randomized crossover trial · n=59

VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study.

Cited 274 times in the scientific literature.

Level 2 - randomized trial

Individual randomized, double-blind, placebo-controlled crossover trial

PubMed 20453678 · doi:10.1097/MPG.0b013e3181ca4d95 · record verified 2026-08-30

What was done

Children and adolescents aged 4 to 18 years meeting eligibility criteria for irritable bowel syndrome (IBS) were enrolled in a multicenter, randomized, double-blind, placebo-controlled crossover trial across 7 pediatric gastroenterology divisions. Following a 2-week baseline assessment via questionnaire, participants were randomized to receive either the probiotic formulation VSL#3 or a placebo for 6 weeks, evaluated every 2 weeks. After a 2-week washout period, participants crossed over to the alternative treatment for an additional 6 weeks.

What was found

A total of 59 children completed the study. VSL#3 was significantly superior to placebo for the primary endpoint of subjective symptom relief (P < 0.05). VSL#3 was also superior in three secondary endpoints: abdominal pain/discomfort (P < 0.05), abdominal bloating/gassiness (P < 0.05), and family assessment of life disruption (P < 0.01). No significant difference was detected in stool pattern (P = 0.06). Placebo response was observed in some parameters in up to 50% of patients. No adverse effects were recorded. Absolute numerical scores and effect sizes were not reported in the abstract.

Why it matters

This study provides evidence that VSL#3 safely improves key clinical symptoms and reduces life disruption in pediatric patients with IBS.

Limits

The abstract reports on 59 completers without specifying the initial number enrolled or dropout rate. Absolute numerical values, baseline severity, and confidence intervals are omitted. The 2-week washout period may be insufficient to prevent probiotic carryover effects, and stool patterns did not significantly improve.

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