Utilisation of dietary fibre (non-starch polysaccharide and resistant starch) molecules for diarrhoea therapy: A mini-review

doi:10.1016/j.ijbiomac.2018.10.195

International Journal of Biological Macromolecules

Volume 122, 1 February 2019, Pages 572-577

https://doi.org/10.1016/j.ijbiomac.2018.10.195 Get rights and content

Abstract

Within the last ten years the utilisation of dietary fibre formats (non-starch polysaccharide and resistant starch) for diarrhoea therapy, have been evaluated. These polysaccharides ferment within the colon and generate short chain fatty acids which facilitate sodium absorption. Comparisons between polysaccharide structure/physico-chemical properties and fermentation capacity in the large intestine are presented. The potential dichotomy associated with recommending dietary fibre ingestion to avoid and treat diarrhoea is also considered. Overall, this mini-review presents an overview of the current knowledge with respect to role of dietary fibre in the management (prevention and treatment) of diarrhoea (osmotic and secretory). It aims to inform the medical and non-medical communities with respect to this relatively poorly researched and understood health related area. Different forms of dietary fibre are considered in this context along with their mechanisms of action.

Section snippets

Diarrhoea and treatments

Diarrhoea is a debilitating and life-threatening condition associated with extreme losses of fluid and salts from the body in the form of watery stools [1]. It has a number of causes and a range of therapies have been developed to treat the cause(s) and symptoms [1]. Diarrhoea may be osmotic or secretory in origin. In the case of osmotic diarrhoea, un-absorbed sugars (or other low molecular weight molecules) for example, may induce diarrhoea as a consequence of their osmotic impact in the gut.

Dietary fibre

Western diets are in general deficient in dietary fibre. Adults should be consuming 30 g/day [6] dietary fibre although, the reality is, that most people in the west ingest much less. According to Hoy and Goldman [7] and Lockyer et al. [8], people in the USA and UK respectively eat about half this amount each day. This leads to many potential disease risks both within and outside the digestive system.

According to The Scientific Advisory Committee on Nutrition [6]: ‘There is no universal

Use of dietary fibre to treat diarrhoea

The use of dietary fibre for the treatment of diarrhoea (outside of usage for enteral food applications) is poorly researched [25]. This might be because some individuals consider it counter intuitive to use fibre in this context in view of its gut transit stimulation and water holding capacity. Stool weight increases as a consequence of fibre intake as water in particular is retained in the stool mass more effectively - the volume/mass of which is dependent on type and amount of dietary fibre

Mechanism of dietary fibre functionality in the gut

Although dietary fibre may improve symptoms and shorten the duration of diarrhoea, further research seems to be necessary before recommendations can be made regarding more specific usage for this purpose [25]. Insoluble fibre has limited water-holding capacity and hence is not beneficial for controlling loose stools in diarrhoea - it may make it worse [28]. de Vasconcelos Generoso et al. [29] reported that viscous soluble dietary fibre represents the best option for treating diarrhoea whereas

Conclusions

In many ways, counter intuitively, fibre (essentially plant polysaccharide molecules) promotes healthy faecal bulk in health, during constipation and during diarrhoea. Most often people consider that dietary fibre promotes defaecation when the reality is that it regulates luminal volume of faecal matter in health and disease. This effect is associated mostly with soluble fibres that can regulate the faecal solid to water volume and consequently water retention/absorption/loss from the body in

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ReviewUtilisation of dietary fibre (non-starch polysaccharide and resistant starch) molecules for diarrhoea therapy: A mini-review

Abstract

Section snippets

Diarrhoea and treatments

Dietary fibre

Use of dietary fibre to treat diarrhoea

Mechanism of dietary fibre functionality in the gut

Conclusions

Curr. Opin. Pharmacol.

Cell

J. Lipid Res.

Food Hydrocoll.

Food Hydrocoll.

Clin. Nutr. Suppl.

Gastroenterology

Nutrition

LWT–Food Sci. Technol.

Gastroenterology

Clin. Nutr.

Clin. Nutr.

Bioact. Carbohydr. Diet. Fibre

Int. J. Pharm.

Carbohydr. Polym.

Starch containing formulations for diarrhoea therapy

Clin. Nutr. ESPEN

Review article: the history of acute infectious diarrhoea management - from poorly focused empiricism to fluid therapy and modern pharmacotherapy

Aliment. Pharmacol. Ther.

Oral rehydration therapy: new explanations for an old remedy

Annu. Rev. Physiol.

Mammalian sugar transporters, glucose homeostasis

Carbohydrates and Health, Norwich and Belfast, The Stationery Office

Fibre intake of the U.S. population: What we eat in America

Dietary fibre and the prevention of chronic disease - should health professionals be doing more to raise awareness?

Nutr. Bull.

Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health

Nutr. Res. Rev.

Effect of native starch granule size on susceptibility to amylase hydrolysis

Starch-Starke

Effect of composition and structure of native starch granules on their susceptibility to hydrolysis by amylase enzymes

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Heat and moisture modification of native starch granules on susceptibility to amylase hydrolysis

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Is starch or maltodextrin ‘glucose’?

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Dietary fibre, gastric emptying and carbohydrate digestion: a mini-review

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Health properties of resistant starch

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Intestinal short chain fatty acids and their link with diet and human health

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Nutr. Bull.

Review
Utilisation of dietary fibre (non-starch polysaccharide and resistant starch) molecules for diarrhoea therapy: A mini-review