Caspian J Intern Med 2021; 12(2): 194-199 DOI: 10.22088/cjim.12.2.194 Original Article Copyright © 2020, Babol University of Medical Sciences This open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 Azade Gholizadeh 1 Sanaz Mehrabani (MD) 2* Mohammadreza Esmaeili Dooki (MD) 2 Mahmood Haji Ahmadi (PhD) 2 1. Student Research Committee, Babol University of Medical Sciences, Babol, Iran 2. Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran * Correspondence: Sanaz Mehrabani, Non- Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran E-mail: Mehrabanisanaz@gmail.com Tel: 0098 1132346963 Fax: 0098 1132346963 Received: 18 March 2020 Revised: 28 July 2020 Accepted: 1 Aug 2020 Effect of a synbiotic on functional abdominal pain in childhood Abstract Background: One of the common functional gastrointestinal disorders in children is functional abdominal pain (FAP). The aim of the present study was to determine whether the administration of a synbiotic composed of fructo-oligosaccharides (FOS) and the seven types of beneficial bacteria is useful in FAP of childhood. Methods: In this placebo-controlled, double-blind trial, 4-15-year-old children who met the Rome III criteria for FAP were randomly divided to receive either synbiotic or placebo twice daily for 4 weeks. Primary outcome was at least 50% reduction in the number of pain episodes, and secondary outcomes were a decline of at least two scales in the pain duration and intensity based on Wong-Baker scale. Response to therapy was decrease of pain frequency/intensity. Results: A total of 67 children completed the trial (35 with synbiotic). Response rate was higher with synbiotic than placebo after four weeks (53.1 vs 11.4%; p<0.001), and synbiotic had significant superiority to placebo to relieve the duration (4.56±9.12 vs12±18.59, min/day, P=0.04), frequency (0.31±0.53vs 1.17±0.7, episode/Wk., P<.001) and intensity (2.38±2.29 vs 5.49±1.83, p<0.001) of abdominal pain. Conclusion: Synbiotic compared to placebo significantly decreased the intensity, frequency and duration of FAP in children. Keywords: Abdominal pain, Child, Synbiotic. Citation: Gholizadeh A, Mehrabani S, Esmaeili Dooki M, Haji Ahmadi M. Effect of a synbiotic on functional abdominal pain in childhood. Caspian J Intern Med 2021; 12(2): 194-199. F unctional abdominal pain disorders (FAPDs) are common in children which can be divided into irritable bowel syndrome (IBS), abdominal migraine, functional abdominal pain (FAP) and functional dyspepsia (FD) (1, 2). The FAP is more common in schoolchildren with the prevalence of 8 and 10-15% in western countries (3, 4). According to the studies, the prevalence of recurrent abdominal pain was 11.8, 8 and 17% in 2-6-year-old children, middle school children and adolescents, respectively (5, 6). Among the children, the FAP has short- and long-term complications including lifetime psychiatric disorders, depression, social phobia, anxiety and somatic complaints (7). Although the patients’ burden is the poor quality of life as long-term consequences compared to the general population and patients with other chronic conditions (8). Absenteeism of school is an undesirable outcome in adolescents leading to school dropout, substance abuse and violence (7). There are no structural and biochemical abnormalities, except clinical symptoms to diagnose the FAP (9). Because the pathophysiology of FAP is not yet clear, there is a therapeutic challenge for pediatric gastroenterologists in children with FAP (4).