Suppressive effect of partially hydrolyzed guar gum on transitory diarrhea induced by ingestion of maltitol and lactitol in healthy humans

Abstract

Objectives: To estimate the suppressive effect of partially hydrolyzed guar gum (PHGG) on transitory diarrhea induced by ingestion of a sufficient amount of maltitol or lactitol in female subjects. Design: The first, the minimal dose level of maltitol and lactitol that would induce transitory diarrhea was estimated separately for each subject. Individual subject was administered a dose that increased by 5 g stepwise from 10 to 45 g until diarrhea was experienced. Thereafter, the suppressive effect on diarrhea was observed after each subject ingested a mixture of 5 g of PHGG and the minimal dose level of maltitol or lactitol. Setting: Laboratory of Public Health Nutrition, Department of Nutrition and Health Sciences, Siebold University of Nagasaki. Subjects: Thirty-four normal female subjects (21.370.9 years; 49.575.3 kg). Main outcome measurement: Incidence of diarrhea caused by the ingestion of maltitol or lactitol and the ratio of suppression achieved by adding PHGG for diarrhea. Results: The ingestion of amounts up to 45 g of maltitol, diarrhea caused in 29 of 34 subjects (85.3%), whereas the ingestion of lactitol caused diarrhea in 100%. The diarrhea owing to maltitol was improved in 10 of 28 subjects by the addition of 5 g of PHGG to minimal dose-induced diarrhea, and that owing to lactitol was in seven of 19 subjects. Adding 10 g of PHGG strongly suppressed the diarrhea caused by maltitol, and the cumulative ratio was 82.1% (23/28). Conclusion: The transitory diarrhea caused by the ingestion of maltitol or lactitol was clearly suppressed by the addition of PHGG. These results strongly suggest that diarrhea caused by the ingestion of a sufficient amount of non-digestible sugar substitute can be suppressed by the addition of dietary fiber.

Scientific Opinion on the use of Polyglycitol Syrup as a food additive

“…The SCF (1989) described the laxation caused by osmotic pressure as "osmotic diarrhoea", in order to differentiate it from the term "diarrhoea" which is commonly used to describe a gastro-enteric sickness. Maltitol and lactitol have been described as inducing transitory osmotic diarrhoea in humans by the hyperosmotic retention of fluids in the small and large intestines at doses down to 15 g (Nakamura et al, 2007). Upon regular consumption of maltitol and other polyols (daily for two 9-day periods), the occurrence of an intestinal adaptation to maltitols laxative effect at doses of up to 30 g has been reported in some individuals (Brommage et al, 1993;Ruskoné-Fourmestraux et al, 2003).…”

Utilidad en la clínica de la goma guar parcialmente hidrolizada: revisión de la evidencia y experiencia

“…También se ha estudiado el uso de la GGPH en la diarrea no asociada a nutrición enteral, encontrándose resultados positivos en pacientes con diarrea severa por cólera, si bien es difícil determinar la dosis óptima en este tipo de pacientes (46); y en la diarrea transitoria inducida por maltitol o lactitol en mujeres (47).…”

Suppressive Effect of Cellulose on Osmotic Diarrhea Caused by Maltitol in Healthy Female Subjects

“…The sample was eluted with deionized distilled water at a flow rate of 1.0 mL/min and the injection volume of the sample was 5 L. Calculation and statistical analysis. We used the chisquare test to compare the percentage of the subjects whose osmotic diarrhea was improved by ingesting cellulose, PHA-Na or PHGG ( 9 ). The amount of maltitol remaining in the rat stomach and the amount being transferred to the small intestine at each time point after administration were calculated in terms of means and standard deviations (SD), and we compared the amount among the maltitol group, the maltitol and cellulose group, and the maltitol and PHA-Na group using ANOVA and Tukey's post hoc test.…”

“…In a previous study, we reported that the addition of 5 and 10 g of partially hydrolyzed guar gum (PHGG) to the minimal dose level of maltitol that induced osmotic diarrhea (MMD) suppressed diarrhea in 23 out of 28 subjects (82.1%) ( 9 ). In addition, PHGG improved the diarrhea caused by tube feeding of enteral nutrition in the elderly ( 10 , 11 ) and treated acute diarrhea with infection in children ( 11 , 12 ).…”