Amylase-resistant starch as adjunct to oral rehydration therapy in children with diarrhea - PubMed (original) (raw)

Randomized Controlled Trial

Amylase-resistant starch as adjunct to oral rehydration therapy in children with diarrhea

P Raghupathy et al. J Pediatr Gastroenterol Nutr. 2006 Apr.

Abstract

Background: Oral rehydration solution (ORS) for treatment of diarrhea relies on enhancement of small intestinal sodium and fluid absorption to correct dehydration. Amylase-resistant starch added to ORS significantly reduced the duration and severity of diarrhea in adults with cholera, presumably by generation of short-chain fatty acids in the colon and enhancement of colonic sodium and fluid absorption. The present study was initiated to determine whether addition of amylase-resistant starch to standard World Health Organization glucose-ORS (G-ORS) would reduce the duration of diarrhea and fecal fluid losses in children with acute diarrhea.

Methods: One hundred eighty-three children (6 months to 3 years) with acute watery diarrhea were randomized to receive either standard treatment with G-ORS or G-ORS with additional amylase-resistant starch, HAMS (HAMS-ORS, 50g/L). Stool weight and consistency were monitored serially until development of formed stool or development of treatment failure defined as either the need for unscheduled intravenous fluid therapy or diarrhea longer than 72 hours.

Results: Five of the subjects were lost to follow up. In 178 remaining children (87 HAMS-ORS and 91 G-ORS) with evaluable data, time from enrolment to last unformed stool was significantly less in children receiving HAMS-ORS (median, 6.75 hours; 95% confidence interval, 4.27-9.22) than in children treated with G-ORS (12.80 hours, 8.69-16.91) (P = 0.0292). Time to first formed stool was also significantly shorter in children receiving HAMS-ORS (median, 18.25 hours; 95% confidence interval, 13.09-23.41) compared with children receiving G-ORS (median, 21.50 hours; 95% confidence interval, 17.26-25.74) (P = 0.0440). The total amount of ORS consumed was similar in both groups. There was a trend toward lower mean stool weight in first 24 hours (P = 0.0752) as well as total diarrheal stool weight (P = 0.0926) in patients in the HAMS group compared with the G-ORS group.

Conclusion: In children with acute diarrhea, the addition of amylase-resistant starch to glucose ORS significantly shortened duration of diarrhea compared with standard treatment.

PubMed Disclaimer

Similar articles

• Efficacy of standard glucose-based and reduced-osmolarity maltodextrin-based oral rehydration solutions: effect of sugar malabsorption.
  el-Mougi M, Hendawi A, Koura H, Hegazi E, Fontaine O, Pierce NF. el-Mougi M, et al. Bull World Health Organ. 1996;74(5):471-7. Bull World Health Organ. 1996. PMID: 9002327 Free PMC article. Clinical Trial.
• Thermophilic amylase-digested rice-electrolyte solution in the treatment of acute diarrhea in children.
  Lebenthal E, Khin-Maung-U, Rolston DD, Khin-Myat-Tun, Tin-Nu-Swe, Thein-Thein-Myint, Jirapinyo P, Visitsuntorn N, Firmansyah A, Sunoto S, et al. Lebenthal E, et al. Pediatrics. 1995 Feb;95(2):198-202. Pediatrics. 1995. PMID: 7530834 Clinical Trial.
• Super ORS.
  Bhattacharya SK, Dutta P, Dutta D, Chakraborti MK. Bhattacharya SK, et al. Indian J Public Health. 1990 Jan-Mar;34(1):35-7. Indian J Public Health. 1990. PMID: 2101384 Review.
• Usefulness of ORT in certain special situations of diarrhoeal diseases.
  Dutta P. Dutta P. Indian J Public Health. 1994 Apr-Jun;38(2):44-9. Indian J Public Health. 1994. PMID: 7835995 Review.

Cited by

• The Effect of Buckwheat Resistant Starch on Intestinal Physiological Function.
  Sun ZB, Zhang X, Yan Y, Xu JL, Lu X, Ren Q. Sun ZB, et al. Foods. 2023 May 21;12(10):2069. doi: 10.3390/foods12102069. Foods. 2023. PMID: 37238887 Free PMC article.
• Metabolite-based dietary supplementation in human type 1 diabetes is associated with microbiota and immune modulation.
  Bell KJ, Saad S, Tillett BJ, McGuire HM, Bordbar S, Yap YA, Nguyen LT, Wilkins MR, Corley S, Brodie S, Duong S, Wright CJ, Twigg S, de St Groth BF, Harrison LC, Mackay CR, Gurzov EN, Hamilton-Williams EE, Mariño E. Bell KJ, et al. Microbiome. 2022 Jan 19;10(1):9. doi: 10.1186/s40168-021-01193-9. Microbiome. 2022. PMID: 35045871 Free PMC article.
• The Combined Beneficial Effects of Postbiotic Butyrate on Active Vitamin D3-Orchestrated Innate Immunity to Salmonella Colitis.
  Huang FC, Huang SC. Huang FC, et al. Biomedicines. 2021 Sep 22;9(10):1296. doi: 10.3390/biomedicines9101296. Biomedicines. 2021. PMID: 34680413 Free PMC article.
• Contribution of Dietary Composition on Water Turnover Rates in Active and Sedentary Men.
  Disher AE, Stewart KL, Bach AJE, Stewart IB. Disher AE, et al. Nutrients. 2021 Jun 21;13(6):2124. doi: 10.3390/nu13062124. Nutrients. 2021. PMID: 34205676 Free PMC article.
• Development and Pathophysiology of Oral Rehydration Therapy for the Treatment for Diarrhea.
  Binder HJ. Binder HJ. Dig Dis Sci. 2020 Feb;65(2):349-354. doi: 10.1007/s10620-019-05881-3. Dig Dis Sci. 2020. PMID: 31659613 Review. No abstract available.

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • Ovid Technologies, Inc.
  • Wiley
  • Wolters Kluwer

• Other Literature Sources

  • The Lens - Patent Citations Database

• Medical

  • MedlinePlus Health Information