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Does super efficient starch absorption promote diverticular disease?

J R Thornton, A Dryden, J Kelleher

    British Medical Journal (Clinical Research Ed.)
    |June 28, 1986
    PubMed
    Summary
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    Patients with diverticular disease absorb starch more efficiently, meaning less reaches the colon. This suggests highly efficient starch absorption may contribute to developing diverticular disease.

    Area of Science:

    • Gastroenterology
    • Human Physiology
    • Nutritional Science

    Background:

    • Diverticular disease is a common condition affecting the colon.
    • The role of undigested carbohydrates reaching the colon in diverticular disease pathogenesis is not fully understood.
    • Starch malabsorption has been proposed as a potential factor.

    Purpose of the Study:

    • To quantify the amount of starch escaping absorption in the small intestine in patients with symptomatic diverticular disease compared to healthy controls.
    • To investigate the relationship between starch absorption efficiency and the development of diverticular disease.

    Main Methods:

    • Eight patients with symptomatic diverticular disease and eight healthy controls participated.
    • Breath hydrogen measurements were used to assess unabsorbed starch after a potato meal.

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  • Lactulose breath tests were employed as a reference for hydrogen response.

    • Main Results:

    • Patients with diverticular disease exhibited significantly lower starch malabsorption (mean 3.3%) compared to controls (12.4%; p < 0.01).
    • The proportion of unabsorbed starch was approximately one-quarter in patients versus controls.
    • This indicates a higher efficiency of starch digestion and absorption in patients.

    Conclusions:

    • Unabsorbed starch reaching the colon is a significant source of carbohydrate.
    • Super-efficient starch absorption in the small intestine may reduce carbohydrate delivery to the colon.
    • Reduced colonic carbohydrate provision due to enhanced starch absorption could be a contributing factor in the development of diverticular disease.