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Efficacy and tolerability of α-galactosidase in treating gas-related symptoms in children: a randomized, double-blind, placebo controlled trial

Giovanni Di Nardo1, Salvatore Oliva1, Federica Ferrari1, Saverio Mallardo1, Giovanni Barbara2, Cesare Cremon2, Marina Aloi1 and Salvatore Cucchiara1*

Author Affiliations

1 Pediatric Gastroenterology and Liver Unit, Sapienza – University of Rome, Rome, Italy

2 Department of Medical Science, University of Bologna, Bologna, Italy

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BMC Gastroenterology 2013, 13:142  doi:10.1186/1471-230X-13-142

Published: 24 September 2013



Gas-related symptoms represent very common complaints in children. The reduction of gas production can be considered as a valuable target in controlling symptoms. α-galactosidase has been shown to reduce gas production and related symptoms in adults. To evaluate the efficacy and tolerability of α-galactosidase in the treatment of gas-related symptoms in pediatric patients.


Single center, randomized, double-blind, placebo-controlled, parallel group study performed in tertiary care setting. Fifty-two pediatric patients (32 female, age range 4–17) with chronic or recurrent gas-related symptoms were randomized to receive placebo (n = 25) or α-galactosidase (n = 27). Both treatments were given as drops or tablets, according to body weight for 2 weeks. The primary endpoint was the reduction in global distress measured by the Faces Pain Scale-Revised (FPS-R) at the end of treatment compared to baseline. Secondary endpoints were the reduction in severity and frequency of gas-related symptoms as recorded by parents and/or children.


α-galactosidase significantly reduced global distress (p = 0.02) compared to placebo. The digestive enzyme decreased the number of days with moderate to severe bloating (p = 0.03) and the proportion of patients with flatulence (p = 0.02). No significant differences were found for abdominal spasms and abdominal distension. No adverse events were reported during treatment.


Although larger and longer trials are needed to confirm this result, α-galactosidase seems to be a safe, well tolerated and effective treatment for gas-related symptoms in the pediatric population.

Trial registration, NCT01595932

Gas-related symptoms; Bloating; α-galactosidase; Children