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World J Gastroenterol. 2017 Dec 7;23(45):7952-7964. doi: 10.3748/wjg.v23.i45.7952.

Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region.

Author information

1
Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Melbourne 3052, Australia. don.cameron@rch.org.au.
2
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
3
Child Health Department, Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta 12220, Indonesia.
4
Department of Pediatric Gastroenterology, Hepatology And Liver Transplantation, Medanta The Medicity 122001, Gurugram Haryana, India.
5
Department of Pediatrics, Gachon University, Gil Gachon Children's Hosptial, Incheon 21565, South Korea.
6
Department of Paediatric Gastroenterology, Royal Hospital for Children, Bristol BS2 8BJ, United Kingdom.
7
Probiotics Research Laboratory, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan.
8
The Children's Hospital, Zhejiang University School of Medicine, Hangzhou 610041, Zhejiang Province, China.
9
Department of Pediatrics, Hieronymus Bosch Hospital, 's-Hertogenbosch 5223GZ, The Netherlands.
10
Unit of Pediatrics Infectious Diseases and Clinical Nutrition of the Department of Translational Medical Science-Section of Pediatrics, University of Naples Federico II, Naples 80131, Italy.

Abstract

Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system. Saccharomyces boulardii CNCM I-745 (Sb) and Lactobacillus rhamnosus GG (LGG) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacillus reuteri could also be considered. Probiotics may be considered for prevention of (with the indicated strains): antibiotic-associated diarrhea (LGG or Sb); Clostridium difficile-induced diarrhea (Sb); nosocomial diarrhea (LGG); infantile colic (L reuteri) and as adjunct treatment of Helicobacter pylori (Sb and others). Specific probiotics with a history of safe use in preterm and term infants may be considered in infants for prevention of necrotizing enterocolitis. There is insufficient evidence for recommendations in other conditions. Despite a diversity of epidemiological, socioeconomical and health system conditions, similar recommendations apply well to Asia pacific countries. These need to be validated with local randomized-controlled trials.

KEYWORDS:

Asia-Pacific; Children; Gastroenteritis; Guidelines; Lactobacillus rhamnosus; Probiotics; Recommendations; Saccharomyces boulardii

PMID:
29259371
PMCID:
PMC5725290
DOI:
10.3748/wjg.v23.i45.7952
[Indexed for MEDLINE]
Free PMC Article

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