Summary of findings 13. Kefir ( Lactobacillus bacteria) compared to no intervention for the management of abdominal pain in Crohn's disease and inflammatory bowel disease.

Kefir (Lactobacillus bacteria) compared to no intervention for the management of abdominal pain in Crohn's disease and inflammatory bowel disease
Patient or population: people with inflammatory bowel disease Setting: unstated (single centre, Turkey) Intervention: kefir Comparison: no intervention
Outcomes	Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	№ of participants (studies)	Certainty of the evidence (GRADE)
	Risk with no intervention	Risk with kefir
Treatment success as defined by the authors	‐	‐	‐	‐	Not measured
Abdominal pain frequency or change in frequency	‐	‐	‐	‐	Not measured
Pain intensity IBD  (4‐point rating scale from 0 to 3)	‐	MD 0.62 higher (0.17 higher to 1.07 higher)	‐	48 (1 study)	⊕⊕⊝⊝ very low a b
Pain intensity CD (4‐point rating scale from 0 to 3)	‐	MD 1.10 lower (1.67 lower to 0.53 lower)	‐	20 (1 study)	⊕⊕⊝⊝ very low a b
Withdrawals due to adverse events	0 per 1000	0 per 1000 (0 to 0)	Not estimable	20 (1 study)	⊕⊝⊝⊝ very low a b
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CD: Crohn's disease; CI: confidence interval; IBD: inflammatory bowel disease; MD: mean difference
GRADE Working Group grades of evidence High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect.

^aDowngraded one level due to risk of bias.
^bDowngraded two levels due to imprecision from very sparse data.