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

Donald Cameron, Quak Seng Hock, Muzal Kadim, Neelam Mohan, Eell Ryoo, Bhupinder Sandhu, Yuichiro Yamashiro, Chen Jie, Hans Hoekstra, Alfredo Guarino

Research output: Contribution to journalReview articlepeer-review

55 Citations (Scopus)


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 boulardi CNCM I-745 (Sb) and Lactobacilus rhamnosus GG (LGG) were strongly recommended as adjunct treatment to oral rehydration therapy for gastroenteritis. Lactobacilus 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.

Original languageEnglish
Pages (from-to)7952-7964
Number of pages13
JournalWorld Journal of Gastroenterology
Issue number45
Publication statusPublished - 7 Dec 2017


  • Asia-Pacific
  • Children
  • Gastroenteritis
  • Guidelines
  • Lactobacilus rhamnosus
  • Probiotics
  • Recommendations
  • Saccharomyces boulardii


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