L. reuteri DSM 17938 modestly shortens pediatric acute gastroenteritis diarrhea by 0.68 daysLimosilactobacillus reuteri May Shorten Diarrhea Duration in Children

Frontiers in Medicine Published October 16, 2026 DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Interpret the 0.68-day diarrhea reduction cautiously given very low certainty evidence.

This meta-analysis pooled randomized trials of Limosilactobacillus reuteri DSM 17938 in children with acute gastroenteritis, analyzing 527 of 565 randomized children for the primary outcome. The primary outcome was duration of diarrhea, with secondary outcomes of persistence at 48 and 72 hours.

For duration of diarrhea, the intervention reduced duration by 0.68 days (95% CI -1.09 to -0.27). Persistence of diarrhea was lower at 48 hours (effect size 0.45, 95% CI 0.29 to 0.69) and at 72 hours (effect size 0.41, 95% CI 0.23 to 0.72). No adverse events or serious adverse events were reported, and the tolerability was described as a favorable safety profile.

The authors note high heterogeneity and risk of bias concerns. Certainty of evidence was very low for diarrhea duration and low for persistence at 48 to 72 hours. Practice relevance is limited: findings should be interpreted with caution in clinical practice due to very low certainty of evidence for the primary outcome. Follow-up duration and funding or conflicts were not reported.

How this fits prior evidence

This meta-analysis extends prior pediatric acute gastroenteritis coverage, which has focused on ondansetron for vomiting and diagnostic testing rather than probiotic therapy. Prior coverage found no benefit of liquid ondansetron at triage for reducing observation time and noted that persistent vomiting after ED discharge is associated with higher unscheduled care and hospitalization. The current findings on L. reuteri DSM 17938 address a gap in adjunctive management of diarrhea duration, but the very low certainty for the primary outcome and high heterogeneity mean the modest 0.68-day reduction should be weighed against the more established, though mixed, evidence for antiemetic strategies.

Researchers looked at data from 565 children to see if the probiotic Limosilactobacillus reuteri DSM 17938 could help manage acute gastroenteritis. The study focused on how long the diarrhea lasted and whether it continued after the first few days of illness.

The analysis showed that children taking this probiotic had a shorter duration of diarrhea compared to those who did not. The results also suggested a lower likelihood of diarrhea persisting at 48 hours and 72 hours. No serious safety concerns or adverse events were reported during the study.

It is important to note that the evidence for these findings is currently considered to be of low to very low certainty. Because the data comes from a meta-analysis with high variation between studies, these results should be viewed with caution. Talk to a doctor to see if this probiotic is a suitable option for your child.

What this means for you:

This probiotic may shorten diarrhea in children, but the evidence is currently limited and not yet certain.

Common questions

Can this probiotic help my child with diarrhea?

The study suggests that Limosilactobacillus reuteri DSM 17938 may reduce the duration of diarrhea in children with acute gastroenteritis. However, the evidence for this specific outcome is considered to be of very low certainty. You should consult your pediatrician to determine if this is appropriate for your child's specific needs.

Is it safe for children to take this probiotic?

The study reported a favorable safety profile for Limosilactobacillus reuteri DSM 17938. No serious adverse events or safety concerns were reported during the evaluation. Because the evidence is still limited, always speak with a healthcare provider before starting any new supplement.

How much faster does the diarrhea stop with this treatment?

The analysis showed a reduction in the duration of diarrhea by an average of 0.68 days. It also showed a lower likelihood of diarrhea persisting at 48 hours and 72 hours. Because of the low certainty of the data, these numbers should be interpreted with caution.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedOct 2026

View Original Abstract ↓

IntroductionAcute gastroenteritis (AGE) remains a major global clinical concern in pediatric populations. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Limosilactobacillus reuteri DSM 17938 for the treatment of acute gastroenteritis in children, with the duration of diarrhea as the primary outcome.MethodsA comprehensive literature search was conducted across MEDLINE (via PubMed), Embase, Scopus, and the Science Citation Index Expanded from inception to April 1, 2026. Two independent reviewers performed study selection, data extraction, and risk of bias assessment using the Cochrane RoB 2 tool. Random-effects models pooled mean differences (MD) and risk ratios (RR), and the certainty of the evidence was appraised via the GRADE approach.ResultsSix randomized controlled trials involving 565 randomized children (527 analyzed for the primary outcome) met the inclusion criteria. Limosilactobacillus reuteri DSM 17938 significantly reduced the duration of diarrhea by a mean difference of 0.68 days (95% CI: -1.09 to -0.27). Furthermore, the persistence of diarrhea was significantly lower in the probiotic group at 48 hours (RR 0.45, 95% CI 0.29 to 0.69) and 72 hours (RR 0.41, 95% CI 0.23 to 0.72). No serious or treatment-related adverse events were reported across the trials. The certainty of the evidence was rated as very low for diarrhea duration and low for persistence at 48-72 hours due to high heterogeneity and risk of bias concerns.DiscussionLimosilactobacillus reuteri DSM 17938 produces a modest reduction in the duration of diarrhea and a substantial decrease in persistence at 48-72 hours, accompanied by a favorable safety profile. However, due to the very low certainty of the evidence regarding the primary outcome, these findings should be interpreted with caution in clinical practice.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261449562, PROSPERO CRD420261449562.

L. reuteri DSM 17938 modestly shortens pediatric acute gastroenteritis diarrhea by 0.68 daysLimosilactobacillus reuteri May Shorten Diarrhea Duration in Children

How this fits prior evidence

Common questions

Study Details

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L. reuteri DSM 17938 modestly shortens pediatric acute gastroenteritis diarrhea by 0.68 daysLimosilactobacillus reuteri May Shorten Diarrhea Duration in Children

How this fits prior evidence

Common questions

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