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Discussion Starter · #1 ·
I saw this and although we don't have cholera, I thought this was interesting. What do you guys think about it, just curious.Addition of Maize Starch to OralRehydration ReducesCholera-Associated Diarrhea WESTPORT, Feb 03 (Reuters Health) - Administration of anamylase-resistant starch with oral rehydration reduces fecalfluid loss and shortens the course of diarrhea in cholerapatients, according to a report in the February 3rd issue of TheNew England Journal of Medicine.Dr. B. S. Ramakrishna, from Christian Medical College andHospital in Vellore, India, and colleagues studied the effects oncholera-associated diarrhea of three oral rehydration regimens:standard oral rehydration (16 patients), oral rehydrationsupplemented with rice flour (16 patients), and oral rehydrationsupplemented with high-amylose maize starch (16 patients). Inall cases the duration of diarrheal illness was less than 72hours.The authors explain that high-amylose maize starch eludesabsorption in the small intestines and is converted in the colonto short-chain fatty acids, which have been shown to reversethe diminished colonic absorption of fluids caused by cholera.Fecal fluid loss, as measured by fecal weight, was significantlylower in the maize starch group than in the standard rehydrationgroup beyond the first 12 hours of treatment, the authors report.At between 36 and 48 hours, patients receiving maize starchalso showed lower fecal fluid losses than did the patients whoreceived rice flour.Patients in the maize starch group were also quicker to produceformed stools (56.7 hours) than were the standard rehydrationpatients (90.9 hours) or those who received rice flour (70.8hours), the results indicated. Fecal starch during a 48-hourrecovery period was two to three times higher in the maizestarch group than in the standard rehydration and rice-flourgroups."Our findings indicate that the duration of diarrhea wassignificantly shortened, and the loss of fluid in stoolsconsiderably reduced, when resistant starch was administeredin addition to the standard oral rehydration solution and whenpatients were encouraged to eat as soon as possible after theadministration of the solution," the authors conclude."In cholera, the most potent treatment to reduce diarrhea is theuse of an appropriate antibiotic (tetracycline or doxycycline) towhich the organisms are susceptible," notes Dr. G. H. Rabbani,from the International Centre for Diarrhoeal Disease Researchin Dhaka, Bangladesh, in a related editorial."Further studies will be needed to determine whether[resistant-starch] therapy leads to clinical improvement whengiven along with the standard treatment of cholera, includingthe early administration of antibiotics," Dr. Rabbani writes."For treating cholera, the solution [Dr. Ramakrishna's group]used could theoretically be combined with the rice-basedsolution, which has already been proved valuable."N Engl J Med 2000;342:308-313,345-347.------------------ http://webpotential.com/ericibs/index.htm
 

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Discussion Starter · #4 ·
K9, it is corn starch. I hope one of those two see this.
 

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Sorry, Eric, I'm not Guy or Flux either.
I just want to say it's a very interesting article. I wonder in what form they gave it to them?Jean------------------"Never let the fear of striking out get in your way." Babe Ruth. And I'm also Praying with Bettie for a cure for this NASTY IBS! Jean
 
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Eric,Here's something that's related...--------------------------------------------J Pediatr Gastroenterol Nutr 1996 Oct;23(3):280-6 Fecal short-chain fatty acids in patients with diarrhea-predominant irritable bowel syndrome: in vitro studies of carbohydrate fermentation.Treem WR, Ahsan N, Kastoff G, Hyams JSDivision of Pediatric Gastroenterology and Nutrition, Duke University Medical Center, Durham, North Carolina, USA. Colonic bacterial production of short-chain fatty acids (SCFA) plays an important role in the salvage of unabsorbed carbohydrate and in colonic absorption of electrolytes and water. The objective of this study was to determine whether patients with diarrhea-predominant irritable bowel syndrome (DP-IBS) have a different pattern and rate of fermentation of carbohydrate and fiber to SCFA compared with controls. Fecal homogenates from 10 patients with DP-IBS and 10 age-matched controls were studied. SCFA were measured by gas chromatography in baseline fecal samples and in fecal homogenates in an in vitro anaerobic fermentation system after incubation with no additional substrate, lactulose, potato starch, citrus pectin, and hemicellulose over a 24-hour period. Net SCFA production rates were calculated for the first 6 h of the incubation period. Patients with DP-IBS had a consistently different pattern of less total SCFA, a lower percentage of acetate (p < 0.05), and a higher proportion of n-butyrate (p < 0.05) than controls. In stool homogenates from both controls and DP-IBS patients, lactulose fermentation resulted in the highest rate of SCFA production followed by pectin, starch, and hemicellulose. However, at all time points, the fecal homogenates from controls generated a higher concentration of total SCFA, acetate, and propionate with all substrates tested. SCFA production rates were higher in controls incubated with lactulose, starch, and hemicellulose. The fecal SCFA profile of patients with DP-IBS is characterized by lower concentrations of total SCFA, acetate, and propionate and a higher concentration and percentage of n-butyrate. Fecal flora from these patients produced less SCFA in an in vitro fermentation system in response to incubations with various carbohydrates and fibers. Differences in SCFA production by colonic bacterial flora in patients with DP-IBS may be related to the development of gastrointestinal symptoms. ---------------------------------------------Short chain fatty acids (SCFAs) stimulate sodium and chloride absorption from the colon and at least partially inhibit chloride secretion into the gut, so the results of the article you presented are consistent with earlier research. The abstract above suggests that D-predominant IBS sufferers make less SCFA than those without IBS, so one possibility for D's to try would be to consume foods which produce large quantities of SCFAs.
 

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Discussion Starter · #8 ·
Thanks Guy, pretty interesting. I am with K9 at the moment. I have to look into those foods for curiousity sake.
 

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One interesting question is why do antibiotics cause diarrhea. Well, the bacteria are making the SCFAs and if you kill them, SCFA production falls off, and lo and behold diarrhea results. We don't know for sure if that is exactly what is happening, but this seems to be part of a good explanation.The simplest way to increase SCFA production is to consume fibers and resistant starches and FOS.People have tried to treat ulcerative colitis and pouchitis by using enemas of SCFAs (such as vinegar), but results have been mixed.SCFAs, particularly butyrate, are supposed to control the cell cycle, reducing the risk of colon cancer.
 

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Discussion Starter · #10 ·
Thanks Flux.
 
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K9mom and eric,SCFAs are formed as a byproduct of fermentation of carbohydrates, particularly complex ones. Citrus fruits, potatoes, whole wheat products and legumes would be examples. The downside, though, might be an increase in intestinal gas production!
 

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Discussion Starter · #12 ·
Thanks Guy,I thought it was interesting.
 
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Well Guy - I was just going to post that very article !!!! I found it on medline the other night and the printout was right on my desk here. Yes, very interesting - not so stupid to check SCFA levels afterall(ahem) . Maybe if they are, in fact, found to be low - one could eat the appropriate fiber (if tolerated) and do something pratical about it.So this study shows that IBS-D types not so good at producing SCFAs (in general) . . . and that may be related to development of GI symptoms.From what I have come across, hemicelluloses yeild the highest levels of SCFAs i.e., oat bran. Interestingly, hemicelluloses BIND BILE ACIDS -- sound familiar ? (this is part of what calcium carbonate {Caltrate} does)- I am not saying that is all the hemicelluloses do but it could be part of the anti-D mechanism.
 

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This is quite interesting.I'm wondering if something like Questran might be a good thing for IBS people in general or have I misunderstood these results?J*
 
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SCFAs may be useful in correcting C, too...--------------------------------------------Biosci Biotechnol Biochem 1998 Sep;62(9):1788-90 Germinated barley foodstuff improves constipation induced by loperamide in rats.Kanauchi O, Hitomi Y, Agata K, Nakamura T, Fushiki TApplied Bioresearch Center, Corporate Research and Development Division Kirin Brewery Co. Ltd., Gunma, Japan. The effects of germinated barley foodstuff (GBF) derived from the aleurone and scutellum fractions of germinated barley low-lignified hemicellulose were examined in Sprague-Dawley rats with constipation induced by loperamide by addition to the diet (2 mg/kg body weight). Bowel movements were higher in the GBF-fed rats than in the cellulose-fed rats used as a control. Fecal water content was also higher in the GBF-fed rats. The concentration of short chain fatty acids in cecal content, especially butyrate, was significantly higher in the GBF-fed rats than in the cellulose-fed rats. These findings suggested that GBF helps normalize defecation not only in diarrhea but also constipation.---------------------------------------------Basically, any carbohydrate rich in dietary fiber or starch is a good potential source of SCFAs. Bring on the shredded wheat and oatmeal!
 

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Discussion Starter · #16 ·
Cool Guy
. We have our own research going on here thanks.
 
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Hi Jeff,Since the Questran sequesters bile acids as does calcium carbonate - uh, what I am trying to say is - one of the things I have been trying to figure out if (in the "CALLING ALL CALTRATE USERS AND EX-USERS")is does it primarily work in people who have excess bile acids (some people without gallbladders) - or do some people with IBS-D who have their gallbladders haveelevated bile acid levels ? And/or - there is something called "toxic bile" ( I need to learn more about it but I think it has to do with a bit of liver dysfunction) - maybe some people benefit by taking the questran or calcium carbonate not because of excess bile acid but because the perhaps normal amounts they have are "toxic" and particularly irritating and perhaps cause D - just as the excessive normal bile acids do. Just a hypothesis. It is interesting that Questran helps the itching that comes with liver damage. Maybe a fairly damaged liver (that produceds "toxic bile"?)is helped by having some of that toxic bile mopped up ? Questran does help a lot of people with D. Of course, it would not be appropritate for C types. Before doing questran, I think it would be better for people to try increasing their SCFAs - afterall, they "play(s)an important role in ... colonic absorption of electrolytes and WATER" ! Yeee Haaa !I think I am getting over tired - better go to bed !
 
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Jeffrey,SCFAs increase electrolyte absorption from the colon and inhibit electrolyte secretion into the gut. To the best of my knowledge, Questran doesn't work that way. Questran binds bile acids. Questran is pretty safe, with constipation as the main side effect, though bowel impaction has been recorded. Questran may also make hemorrhoids worse. A big time problem with Questran is that it significantly interferes with the absorption of practically all orally administered drugs, as well as fat-soluble vitamins.
 
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Guy -Just a somewhat related aside -SCFAs inhibit electrolyte secretion into the gut - that is the mechanism by which the Shaman Botanicals Normal Stool formula is supposed to work. Have you seen their website ? They underwent some pretty comprehensive clinical trials (they were gearing up for FDA approval as a drug initially). Their product apparently inhibits chloride secretion into the gut - this, of course means the water will not follow - into the gut (less watery stool).Well, it only helps secretory diarrhea- when I asked the main tech (MD/Botanist)if they knew if IBS-D was secretory in nature, they said they did not know. It did nothing at all for me.Wheat bran is a good potential source of SCFAs - but from what I understand it has an irritating effect on the colon (and none of the direct water-absorbing benefit of psyllium, for ex) and that is how it gets C types to "go" - I think not good for D types.Have you heard that about it ?
 
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I've been following this thread with some interest. Good one, eric and Guy.It made me think of some anecdotal evidence from my own diet.Even though I don't seem to tolerate bulk supplements well(tried Metamucil and Fibercon and darn near found myself on the pot all day long afterwards), I do seem to have a better NEXT day when I have oatmeal or bran for breakfast in the mornings, and an orange or two during the day. And, even though fast food is tabu and certainly high in fat content, I don't seem to react badly to those orders of french fried potatoes I always get. Baked potato seems to have a good effect the next day, also.While I'm on the topic, I should say also that whatever good effect I recognize from foods always shows up the next day. I may be stating the obvious here, but that fact didn't dawn on me until after about a year of messing with this curse and keeping a food diary. Bad foods seem to have their bad effect on the same day - good foods seem to have their good effect the next day.Anyway, what I wanted to ask eric and Guy, or anyone else for that matter, is: instead of talking in SCFA terms, how about a listing of day-to-day foods that fit this theory. I know some general categories have already been listed on some of these posts, e.g. oat bran, legumes, citrus, etc., but how about some specifics. As I said, an orange, oatmeal, and baked potato (don't want to go as far as to say french fries) seem to have good effects for me.Now I know each individual may react differently to the same kind of food, but how about a list of the day-to-day SCFA producing foods. If each individual can select from that list what works for them, maybe one can maximize the good effects more by altering the diet to include more of that stuff. I know I've increased the number of good days experienced by just adding more oatmeal, oranges, and potatoes to my own diet.Thanks...BJP.S. Is pasta, or some variety of it (like made from semolina) a good SCFA producer?? It seems to be one of my "good" foods.
 
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