A combination of probiotics and prebiotics seemed to be an effective treatment modality for functional dyspepsia, although the individual species and strains that are the most beneficial remain uncertain. Using only probiotics failed to alleviate the symptoms of functional dyspepsia. Little evidence was illustrated for the use of prebiotics or synbiotics to manage functional dyspepsia.

A meta-analysis and systematic review and aimed to examine the efficacy and safety of prebiotics and probiotics to treat functional dyspepsia adult patients.

Through September 2018, EMBASE, MEDLINE, and the Cochrane Controlled Trials Register were extensively searched. Various randomized controlled trials (RCTs) that recruited adults with functional dyspepsia and that compared prebiotics, probiotics, or synbiotics with placebo or no therapy were eligible. 

Two independent researchers carried out data extraction and eligibility assessment. To procure a relative risk (RR) with a 95% confidence interval (CI) of remaining symptomatic after therapy, pooling of the dichotomous symptom data was done. Utilizing a standardized or weighted mean difference with a 95% CI, the continuous data were pooled.

Overall, 1062 citations were identified by the search strategy. Notably, five RCTs were found to be eligible for inclusion. The RR of functional dyspepsia symptoms improving with probiotics or probiotics vs placebo was found to be 1.15. Probiotics and prebiotics demonstrated beneficial effects on symptom scores of functional dyspepsia.

In the context of functional dyspepsia, the data for synbiotics were considerably sparse, and no definite conclusions could be interpreted.

Thus, this meta-analysis has displayed limited evidence for using prebiotics or synbiotics for managing functional dyspepsia. Utilizing only probiotics failed to improve functional dyspepsia symptoms. Notably, the combinations of probiotics and prebiotics appeared to have the most evidence encouraging their usage. However, there is a requisition of more RCTs before the role and true efficacy of probiotics, prebiotics, and synbiotics in functional dyspepsia can be completely comprehended.