Pharmacological treatment options for functional gastrointestinal disorders in children

Functional gastrointestinal disorders (FGIDs) are among the most prevalent and diagnostically challenging conditions in children. Optimal pharmacological treatment strategies remain the subject of ongoing scientific discussion. Objective. To evaluate the efficacy of combined pharmacotherapy regimens including probiotics and trimebutine in relieving abdominal pain and normalizing bowel habits in children with FGIDs. Materials and Methods. A randomized clinical study included 183 children with confirmed FGIDs. Participants were divided into five groups: group 1 (n=41) — Bifidobacterium longum + Enterococcus faecium + trimebutine; group 2 (n=44) — Lactobacillus rhamnosus GG + Bifidobacterium longum CECT 7894 + zinc citrate (Acipol Forte) + trimebutine; group 3 (n=40) — Saccharomyces boulardii + trimebutine; group 4 (n=35) — trimebutine monotherapy; group 5 (n=23) — diet therapy. The evaluated parameters included pain dynamics assessed by the Visual Analogue Scale (VAS), pain relief rate, stool normalization, reduction of bloating, sleep quality, and treatment adherence. Results. The best outcomes were observed in group 2: pain relief in 63.6% of children, stool normalization in 93.2%, reduction of bloating in 97.7%, and a decrease in mean VAS pain score to to 1.1 by (82%) day 60. Group 1 showed positive but less stable dynamics. Group 3 demonstrated moderate efficacy, while trimebutine monotherapy (group 4) and diet therapy (group 5) were the least effective. Conclusion. The combination of Lactobacillus rhamnosus GG + Bifidobacterium longum CECT 7894 + zinc citrate (Acipol Forte) with trimebutine proved to be the most effective therapeutic option for FGIDs in children, providing rapid and sustained symptom relief, improved bowel function, and high treatment adherence with good tolerability. The findings emphasize the importance of probiotic strain selection components that enhance their effect (zinc citrate) for achieving optimal outcomes in FGID management.