Green Banana and Pectin Improve Small Intestinal Permeability and Reduce Fluid Loss in Bangladeshi Children with Persistent Diarrhea

Abstract

To evaluate the effects of green banana and pectin (nondigestible, dietary sources of colonic shortchain fatty acids [SCFA]) on intestinal permeability, 57 boys (5-12 months) with persistent diarrhea (> or = 14 days) were given a week's treatment with a rice-based diet containing either cooked green banana (n = 19), pectin (n = 17), or rice diet alone (n = 21). Intestinal permeability was assessed before and after treatment by giving a lactulose-mannitol (LM) drink and measuring urinary recovery after 5 hr. Treatment with banana significantly (P < 0.05) reduced lactulose recovery, increased mannitol recovery, and decreased the LM ratio, indicating improvement of permeability. Pectin produced similar results. Permeability changes were associated with a 50% reduction in stool weights which correlated strongly (green banana, r2 = 0.84, pectin, r2 = 0.86) with the LM ratio. Green banana-derived and SCFA-mediated stimulation of colonic as well as small bowel absorption is responsible for their antidiarrheal effects. The antidiarrheal effects of green banana and pectin are mediated by improvement of small intestinal permeability in addition to their known colonotrophic effects.

Let’s Go Bananas! Green Bananas and their Health Benefits

“…A green banana diet has been shown in some studies to control diarrhea activity and infants with a history of diarrhea have been successfully treated following consumption of cooked green bananas [9][10][11][12]. In one study, cooked green bananas given to 73 children aged 6-60 months who were infected with intestinal Shigella, resulted in 59 % having no mucous within 5 days.…”

Rotaviral diarrhoea – why it is worth preventing

“…Jednak także i w tej grupie decyzję o czasowym zastosowaniu mieszanek bezlaktozowych (najlepiej bez zmienionego jednocześnie składu białkowe-go) należy podejmować tylko w przypadku pogorszenia klinicznego (zwiększenia się liczby stolców) po wprowadzeniu mleka do diety. Dostępny i zalecany w fazie realimentacji jest także produkt na bazie bananów, zawierający zredukowaną ilość laktozy, bogaty w składniki mineralne i prebiotyki (galaktooligosacharydy oraz naturalnie występujące w bananach α-fruktany) [51].…”

Beneficial Role of Green Plantain [Musa paradisiaca] in the Management of Persistent Diarrhea: A Prospective Randomized Trial

“…The physical characteristics of the stools were recorded by specially trained nursing staff at the bed each time they defecated according to Rabbani's scale (18): liquid, defined as feces taking the shape of the container and easily transferable without sticking to the container surface; soft, defined as being thicker taking the shape of a container but can not be poured easily. It has less water, and formed, defined when it retains its shape, it does not stick to the container, is characterized by the absence of mucus, and it can be weighed easily.…”

“…First, the maturity that increases sugar content through hydrolyzation of their pectin material [15,23] and diminishes the phytochemicals (polyphenols, flavinoids and tannins) present in green plantain [18,20]. Second, the cooking process.…”

“…Green plantain has a high content of ARS or pectin [12,14], which is converted into short-chain fatty acids (SCFAs) that stimulate colonic salt-water absorption [8,16,17], thus reducing diarrheal fluid loss. Furthermore, it has been elegantly shown that both exogenous pectin and the green plantain endogenous pectin [10,18] which produce SCFAs, added to a rice-based diet exert an additional effect on small intestine mucosal recovery, digestion, and transport of macro and micronutrients, by reversing the abnormal mucosal permeability associated with PD [8,18] in infants. Moreover, the polyphenols tannins present in Musa paradisiaca may contribute to its beneficial effects as reported in human health literature [15].…”