The role of the microbiome and the use of probiotics in gastrointestinal disorders in adults in the Asia‐Pacific region ‐ background and recommendations of a regional consensus meeting

Abstract

The Asia‐Pacific region is diverse, with regard to ethnicity, culture, and economic development incorporating some of the world's least and most developed nations. Gastrointestinal diseases are common in the Asia‐Pacific region, and their prevalence, presentation, and management vary considerably within the region. There is growing evidence for an important role for the human gut microbiota in gastrointestinal health. As a consequence, geographic variations in the composition of the gut microbiota may contribute to variations in both the prevalence and response to therapy of specific diseases. Probiotics have been proposed as a valuable option in the prevention and treatment of a number of gastrointestinal illnesses, but the quality of available evidence to support their efficacy is variable. A meeting of international experts in adult and pediatric gastroenterology was held at the Sorbonne University, Paris, France, on April 11 and 12, 2016, to discuss current evidence supporting the use of probiotics in gastrointestinal disorders in the Asia‐Pacific region. This article provides an overview of the discussions held at this meeting and recommends the formation of an Asia‐Pacific Consortium on Gut Microbiota similar to those established in Europe and North America.

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“…A recent randomized controlled trial from Hong Kong showed that gut microbiota manipulation with rifaximin resulted in improvement in symptoms in a subset of patients with FD, which is quite commonly associated with IBS 38, 39 . The other methods of gut microbiota manipulation by probiotics showed mixed results, but these studies were quite heterogeneous 40 …”

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“…Probiotics provide a modest benefit in IBS . Possible mechanisms include increased mass of beneficial bacteria in the GI tract, reversal of the imbalance between the pro‐inflammatory and anti‐inflammatory cytokines, reinforcement of the intestinal mucosal barrier, decreased small intestinal permeability, and normalization of digestive tract motility and its visceral sensitivity . Caution should be exercised in extrapolating the positive effects of specific probiotics to the general class as not all formulations have been shown to improve IBS .…”

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“…addition the relative risk of developing adenoma or CRC in people with a history of adenoma in their family increases to 2 folds (23) . There is evidence that treatment with probiotics may modulate gastrointestinal function and reduce digestive disorders (24) . Fermented products such as short chain fatty acids (SCFA) are produced by the consumption of probiotics (25) .…”