Prevalence and Management of Functional Gastrointestinal Disorders in Infants: An Asian Perspective.

To the Editor:

Scarpato et al. [1] have reported in a recent publication in J Pediatr Gastroenterol Nutr that in a number of surveyed Mediterranean countries the Rome diagnostic criteria are not consistently applied, and that large variability remains in the management of functional gastrointestinal disorders (FGIDs). It is known that FGIDs are very common in Europe in children up to three years of age, but little data exists on the prevalence and management of FGIDs in Asia. At a recent workshop and literature review, a group of health care professionals from China, Indonesia, Malaysia, Singapore, Thailand, Hong Kong, and India has reviewed the available data for their respective countries. Based on a systematic literature search (Embase, CAB Abstracts, MEDLINE, SciSearch, Current Contents, Biosis Previews, Pascal, Emcare, and PubMed), it was concluded that data on the prevalence of FGIDs in Asia, e.g., functional constipation ranging from 0.05% to approximately 7% in Thailand, is scarce with considerable variation depending on the applied criteria, study design, methodology, and/or study populations. Few countries have clear guidelines on the diagnosis and management of FGIDs, and dissemination and implementation is unclear. There is a huge variety of use of over the counter remedies by parents, indicative of the absence of safety, tolerance, and efficacy data. It was concluded that I) well-designed epidemiological studies enabling comparison of the prevalence of FGIDs between Asian countries are urgently needed, II) education of parents, parental reassurance, and nutritional management should be the pillars in the management of FGIDs, and III) the potential and opportunity in nutritional prevention and management of FGIDs in Asia could be further advanced.