A new trend is emerging in Asia as diseases that were once considered “Western” are increasingly found in wealthy countries such as Japan and South Korea, as well as places with growing wealth like China. Gastrointestinal (GI) diseases in particular are becoming more common and have been linked to changing environmental factors brought on by industrialization, changes in diet, improved sanitation, and the increased use of antibiotics. Common GI diseases include colorectal cancer, gastroesophageal reflux disease, ulcerative colitis (UC), inflammatory bowel disease (IBD), and Crohn’s disease (CD). Due to these factors, medical device companies in the GI space should look to expand their business operations in Asia.

Rising Incidence and Prevalence of GI Diseases

A number of studies have highlighted the rapid growth of gastrointestinal diseases in Asian populations during the past two decades. Both incidence and prevalence rates have shown a notable rise, with scientists pointing out that GI diseases are increasingly the cause of morbidity and mortality in Asian countries. In The World Cancer Research Fund’s annual ranking of the top 20 countries with the highest incidence of stomach cancer, Korea (42 per 100,000), Japan (30 per 100,000), and China (23 per 100,000) ranked as numbers 1, 3, and 5 respectively.  With such high rates of stomach cancer, researchers have begun investigating the various environmental and genetic factors that may explain such concerning statistics.

Among the top risk factors for GI diseases, researchers writing for the Gastroenterology and Hepatology Journal listed smoking, urbanization, diet and genetics. Smoking rates remain persistently high throughout Asia and, as developing countries such as China and India struggle with record-setting levels of pollution, the incidence of respiratory diseases is expected to rise, too. Researchers also concluded that the increased consumption of refined sugar, fat, fast food, fatty acids and oils also led to a higher chance of developing a GI disease.

Scientists have identified UC as one of the most common GI diseases afflicting Asian countries. In Japan, its prevalence has risen from about 8 cases per 100,000 in 1985 to nearly 64 cases per 100,000 in 2005. South Korea and Singapore have experienced similar sharp increases in diagnosis rates of UC over the past decades. Correctly diagnosing GI diseases in Asia can be particularly tricky in regions where tuberculosis is common, because tuberculosis infections often cause similar symptoms as GI diseases. In order to handle the rise in GI disease, scientists have called for a multidisciplinary approach that involves training more specialists, raising awareness and increasing collaboration among dietitians surgeons, and radiologists. While GI diseases are still diagnosed less often in Asia than in the West, the rising trend and awareness of stomach and intestinal diseases will undoubtedly lead to greater demand for medical products.

Medical Devices Are Part of the Solution

GI diseases can be treated through drugs or surgery, but medical devices play a vital role in early, accurate diagnosis of potentially life-threatening diseases. Endoscopes are particularly useful instruments that can be used in a wide range of non-invasive or minimally invasive surgical operations. A typical endoscope has a small light and camera that are attached to a long, flexible tube. Demand for endoscopic procedures is increasing globally due to rapid advancements in technology as well as the growing demand for non-invasive or minimally invasive surgical procedures. Other endoscopic products that facilitate the diagnosis and treatment of GI diseases include capsule endoscopy systems, ostomy products, cameras, visualization screens and enteral feeding pumps.

Endoscopy in the Asian Markets

The largest companies with endoscopic product lines include Boston Scientific, Covidien, EndoChoice, Ethicon, Fujifilm, and Olympus. In order to reach the growing demand for endoscopic devices in Asia, some companies are opening new training facilities, launching new greenfield operations, or investigating the possibility of acquisitions or joint ventures.

In April 2015, Boston Scientific purchased an undisclosed stake in Frankenman Medical Equipment Company, a Chinese company based in Suzhou. Frankenman Medical specializes in producing surgical devices, including surgical staplers, and suction and irrigation systems. The agreement signed between the two firms indicates that Boston Scientific will provide training and experience to help Frankenman reach more hospitals and doctors throughout China. The press release noted that, while more than 1 million bile duct stone-removal procedures are performed each year in China, access to such procedures is relatively limited. Boston Scientific will rely on Frankeman’s local expertise to commercialize certain products and sell to Chinese hospitals that are increasingly demanding minimally invasive surgical procedures.

The Japanese company Olympus has also taken note of the rising prevalence of GI diseases and the growing demand for endoscopic procedures. In addition to its three main factories in Japan, Olympus has built a factory in Vietnam, as well as multiple training centers and repair facilities in China and India. The Olympus training centers are built to support doctors and assist them with using Olympus’ equipment. Olympus has targeted China and India because it believes that the availability and use of medical equipment will advance rapidly in the future due to population size and the speed of economic growth.

A number of Asian firms are specializing in producing GI products to meet growing demand. Jinshan Science and Technology Co. (Chongqing, China) is one such company that has produced a number of notable capsule endoscopy systems. These systems are in higher demand because they enable non-invasive procedures. While in the GI tract, a capsule records images, allowing doctors to review pictures at a later time. This significantly cuts down on hospital and healthcare costs. Shenzhen Cluss Electronic Instrument Co. is another Chinese firm specializing in enteral feeding pumps, viewing screens, and other portable electronic devices that assist doctors in monitoring gastrointestinal disorders.

Conclusion

A variety of changing environmental and cultural factors are contributing to the rise of GI diseases throughout Asian countries. Developing nations such as China and India are experiencing exceptionally high demand for minimally invasive surgical procedures, but the relative lack of doctors who have experience with endoscopic procedures in addition to a lack of proper medical equipment has created an imbalance between supply and demand. Medical device manufacturers with endoscopic products are using their technology and services to take advantage of this growing demand.