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Published on: October 9, 2013
Amylase-resistant starch plus oral rehydration solution for cholera
B S Ramakrishna1, S Venkataraman, P Srinivasan
1Department of Gastrointestinal Sciences, Christian Medical College and Hospital, Vellore, India.
The New England Journal of Medicine
|February 3, 2000
Summary
Resistant starch added to oral rehydration solution significantly reduced fluid loss and diarrhea duration in cholera patients. This dietary intervention offers a promising approach to managing cholera symptoms more effectively.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Nutritional Science
Background:
- Standard glucose-based oral rehydration therapy effectively treats dehydration in cholera but does not reduce diarrhea duration.
- Short-chain fatty acids, produced from nonabsorbed carbohydrates, enhance sodium absorption in the colon.
- Investigating nonabsorbed starch as a therapeutic agent for cholera is warranted.
Purpose of the Study:
- To evaluate the impact of orally administered amylase-resistant starch on fecal fluid loss.
- To determine the effect of resistant starch on the duration of diarrhea in cholera patients.
- To compare resistant starch with standard therapy and rice flour supplementation.
Main Methods:
- Randomized controlled trial involving 48 adolescents and adults with cholera.
- Three treatment groups: standard oral rehydration therapy (ORT), ORT + rice flour, and ORT + high-amylose maize resistant starch.
- Primary endpoints included fecal weight over 48 hours and time to first formed stool.
Main Results:
- Resistant starch significantly reduced fecal weight compared to standard ORT at multiple time points (P=0.01 to P=0.001).
- Fecal weight was also lower with resistant starch compared to rice flour from 36 to 48 hours (P=0.01).
- The mean duration of diarrhea was significantly shorter with resistant starch (56.7 hours) versus standard ORT (90.9 hours, P=0.001) or rice flour (70.8 hours, P=0.05).
Conclusions:
- Addition of resistant starch to oral rehydration solution effectively reduces fecal fluid loss in cholera patients.
- Resistant starch supplementation significantly shortens the duration of diarrhea in cholera.
- This amylase-resistant starch represents a beneficial adjunct therapy for cholera management.
Keywords:
AsiaBacterial And Fungal DiseasesCholeraClinical ResearchDeveloping CountriesDiarrheaDiseasesIndiaInfectionsOral RehydrationResearch MethodologyResearch ReportSouthern AsiaTreatmentMore Related Videos
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