NEW YORK, Feb 03 (Reuters Health) -- Adding a digestion-resistant type of
starch to rehydration solutions helps to treat diarrhea caused by cholera,
according to a report.
Cholera is a bacterial infection characterized by severe diarrhea,
vomiting and dehydration. In extreme cases it can lead to death. Cholera and
other diarrheal diseases are among the main causes of death in children in
developing countries, claiming more than 3 million lives each year.
Patients with cholera are currently treated with oral rehydration therapy
to replace fluids and salts. But cholera also causes impaired absorption of
fluids in the large intestine, which can be overcome by giving carbohydrates
that are not digested by the enzyme amylase. Bacteria in the colon ferment these
carbohydrates, producing short-chain fatty acids that boost fluid absorption,
helping to reverse dehydration.
Now, a team of international researchers report oral rehydration solutions
that contain amylase-resistant starch appear to shorten the duration of diarrhea
that can lead to dehydration.
"Our findings indicate that the duration of diarrhea was significantly
shortened, and the loss of fluid in stools considerably reduced, when resistant
starch was administered in addition to the standard oral rehydration solution,"
concludes the study in the February 3rd issue of The New England Journal of
Medicine.
In many instances, standard oral rehydration solutions containing glucose
(sugar) and other substances are enough to limit dehydration and reduce
mortality. These standard solutions prevent the deaths of 1 to 2 million
children each year, writes Dr. G.H. Rabbani with the International Centre for
Diarrhoeal Disease Research in Bangladesh, in an accompanying editorial.
However, the use of standard oral rehydration solutions remains low in
many developing countries, the authors of the study note.
To arrive at their findings, Dr. B.S. Ramakrishna, with the Christian
Medical College and Hospital in Vellore, India, and colleagues, randomly
assigned 48 adolescents and adults with cholera into three treatment groups.
Sixteen patients received a standard oral rehydration solution; 16
patients received the solution and 50 grams of rice flour per liter of oral
rehydration solution; and 16 patients received the solution and 50 grams of a
maize starch that resisted digestion.
Investigators measured fecal weight over the length of time before the
first formed stool. Higher fecal weight correlates with increased fluid loss and
therefore diarrhea.
Results show that fecal weights were significantly lower and the duration
of diarrhea was significantly shorter for patients given the amylase-resistant
starch.
While the findings suggest that the resistant starch appears to limit
dehydration, they may not apply to diarrhea that is not due to cholera.
"A better oral rehydration solution should be effective for treating all
types of diarrhea, and it should be easy to prepare, store and administer,"
Rabbani suggests.
"This new solution should be tested in patients with other forms of
dehydrating diarrhea," he adds.
