Starch containing formulations for diarrhoea therapy

      Highlights

      • Starch in oral rehydration solution.
      • Diarrhoea therapy using alpha-glucans.
      • Sodium absorption facilitated by alpha-glucans.

      Summary

      Diarrhoea therapies in general include a number of approaches (depending on local practise and the cause of the diarrhoea) aimed at: (i) removing the cause (e.g. lactose in the diet); (ii) treating the cause of infection if present (e.g. antibiotics); (iii) reducing the effect of the cause (e.g. adsorbent); (iv) depressing gastric motility and secretions (e.g. various drugs); (v) probiotic bacteria with perhaps prebiotic energy sources and most importantly of all (vi) rehydration using rehydration salt solutions (oral rehydration therapy, ORT, using oral rehydration solutions, ORS). Glucose has been included in ORS formats for rapidly available energy since ORS formats were developed initially– but has the disadvantage of a high osmotic pressure. It is used in modern ORS formats to promote sodium absorption, however. The use of α-glucans (glucose containing oligo- or polysaccharides) in ORS formats is gaining ground in terms of utilisation for diarrhoea – a fairly recent approach to therapy in the western world. The use of different α-glucans in ORS formulations is discussed and strategies for the development further of therapies is investigated. This review is aimed at the scientific and medical communities.

      Keywords

      Abbreviations:

      AMP (adenosine monophosphate), ORS (oral rehydration solution), ORT (oral rehydration therapy), SGLTs (sodium dependent glucose transporters), SCFAs (short chain fatty acids), WHO (World Health Organisation)
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