Amylase‐Resistant Starch as Adjunct to Oral Rehydration Therapy in Children with Diarrhea

Raghupathy, P.; Ramakrishna, B. S.; Oommen, Samuel Philip; Ahmed, Mir Shovkat; Priyaa, G.; Dziura, James; Young, Graeme P.; Binder, Henry J.

doi:10.1097/01.mpg.0000214163.83316.41

Cited by 70 publications

(42 citation statements)

References 19 publications

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“…On the other hand, more recent studies in adults with cholera-like diarrhea episodes, it was found that substituting resistant starch for glucose in hypo-osmolar oral rehydration solution significantly improves response to ORS (RAMAKRISHNA et al, 2008). Similar results were reported in children with acute diarrhea (RAGHUPATHY et al, 2006). In both cases, the addition of resistant starch to glucose ORS significantly shortened duration of diarrhea compared with standard treatment.…”

Section: Time-course Of Diarrhea Episodessupporting

confidence: 73%

Not any type of rice performs equally to improve lactose-induced diarrhea characteristics in rats: is amylose an antidiarrheal factor?

et al. 2012

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The effectiveness of different types of rice in relation to their ability to accelerate diarrhea recovering was evaluated in a rat model of osmotic diarrhea (OD). Animals (90-100 g) received protein free diet until reaching up to 20% weight loss, followed by lactose rich diet (LRD) to induce osmotic diarrhea. Rats presenting osmotic diarrhea were divided into 4 groups, which received lactose rich diet for 4 days from 8 am to 8 pm, and one of three experimental products containing 6% rice flour differing in amylose content during the night: high (HA), intermediate (IA), and low (LA). A group fed stock diet containing equivalent amount of lactose was taken as control and allowed to recover spontaneously. Amylose and viscosity (cp at 25 °C, 10 rpm) of final products were determined. Effectiveness was expressed as the ratio between percentages of normal vs. diarrheic stools during the treatment. Fecal characteristics in this rat model improved only as result of feeding high amylose content (HA) type of rice. In this experimental model of osmotic diarrhea in young rats, the antidiarrheal effects of rice were strongly dependent on the type of diet used and appear to be related to its amylose content.

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Section: Time-course Of Diarrhea Episodessupporting

confidence: 73%

Not any type of rice performs equally to improve lactose-induced diarrhea characteristics in rats: is amylose an antidiarrheal factor?

et al. 2012

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“…They are not in the normal diet, but they are synthesized by colonic bacteria from nonabsorbed carbohydrate. Thus, the addition of resistant starch (RS; starch that is relatively resistant to amylase digestion) to ORS should result in increased production of SCFAs and has been shown to enhance the effectiveness of ORS in the treatment of both cholera in adults and noncholera diarrhea in children (149,150). Subsequent studies established that RS in HO-ORS substantially decreases both stool output and the time to the first formed stool in adults with cholera (151).…”

Section: Scientific Challenges That Remainmentioning

confidence: 99%

Enteric infections, diarrhea, and their impact on function and development

Petri¹,

Miller²,

Binder³

et al. 2008

J. Clin. Invest.

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385

293

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Enteric infections, with or without overt diarrhea, have profound effects on intestinal absorption, nutrition, and childhood development as well as on global mortality. Oral rehydration therapy has reduced the number of deaths from dehydration caused by infection with an enteric pathogen, but it has not changed the morbidity caused by such infections. This Review focuses on the interactions between enteric pathogens and human genetic determinants that alter intestinal function and inflammation and profoundly impair human health and development. We also discuss specific implications for novel approaches to interventions that are now opened by our rapidly growing molecular understanding.

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“…Initially, glucose was the first carbohydrate to be used (Desjeux et al, 1994). Then, rice (Molla et al, 1982;Gore et al, 1992;Desjeux et al, 1994;Dutta et al, 2000) and more recently amylase-resistant starch (ARS) (Ramakrishna et al, 2000Raghupathy et al, 2006) added to glucose ORS has proven to be more effective than glucose ORS without ARS.…”

Section: Introductionmentioning

confidence: 99%

Short-chain fatty acids and commensal microbiota in the faeces of severely malnourished children with cholera rehydrated with three different carbohydrates

et al. 2010

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Background: Short-chain fatty acids (SCFAs) liberated by fermentation of complex carbohydrates might stimulate water and salt absorption, and provide energy. The aim of the study was to assess the number and proportion of faecal bacteria and the concentration of SCFAs of severely malnourished children with cholera receiving oral rehydration solution (ORS) containing glucose, amylase-resistant starch (ARS) or rice. Methods: Serial faecal samples were collected from 30 malnourished children with cholera until rehydration and partial nutritional recovery. SCFAs were identified and quantitated by high-performance liquid chromatography. In situ hybridization combined with flow cytometry was used to analyse the microbiota in the faeces. Results: Before treatment the concentration of total SCFA in faecal sample of cholera children was found to be 4.7±0.6 mmol/kg and it increased steadily until 95.0 ± 8.7 mmol/kg at day 28. Among different ORS groups, concentration was significantly higher in the Rice-ORS group at day 1 (Po0.011) and at day 2 (Po0.025). During recovery faecal output was significantly reduced and the number of bacteria also increased faster in the Rice-ORS group than in the glucose-ORS group at day 1 and day 2 (Po0.01), and a modest increase in bacterial number was observed in the glucose-ORS plus ARS group (day 1, P ¼ 0.07; day 2, P ¼ 0.09). Conclusion: Clinical recovery was associated with an increase in bacterial and SCFA concentrations with all three carbohydrates in ORS. However, the increases were significantly higher in children receiving Rice-ORS.

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Amylase‐Resistant Starch as Adjunct to Oral Rehydration Therapy in Children with Diarrhea

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

Cited by 70 publications

References 19 publications

Not any type of rice performs equally to improve lactose-induced diarrhea characteristics in rats: is amylose an antidiarrheal factor?

Not any type of rice performs equally to improve lactose-induced diarrhea characteristics in rats: is amylose an antidiarrheal factor?

Enteric infections, diarrhea, and their impact on function and development

Short-chain fatty acids and commensal microbiota in the faeces of severely malnourished children with cholera rehydrated with three different carbohydrates

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