Benefits of gum arabic supplementation to oral rehydration solution in managing acute diarrhea
Keywords:
ORS, acute diarrhoea, gum arabic, supplementation, effectiveness study
Abstract
Background Oral rehydration solution (ORS) has been provensuccessfully to overcome dehydration in diarrhea. The improvement
of the effectiveness of ORS is still needed to overcome some failures.
Gum Arabic (GA), an indigestable starch, can enhance ORS
absorption in mice with diarrhea. It is worthy to explore its benefits
in human. Since GA is non toxic to human being, it is regarded
ethical to conduct effectiveness study directly in clinical setting.
Objective To evaluate the effectiveness of GA supplementation
to ORS in managing inpatients diarrheal cases .
Methods A double blind clinical trial was conducted during March
to September 2004 in the Department of Child Health of M. Hoesin
Hospital, Palembang. The subjects were randomly enrolled to GA-
ORS (GA) group or ORS (SO) group. Indirect measurements were
conducted on ORS absorptive enhancement by evaluating the
duration of diarrhea after hospitalization, frequency of defecation
during hospitalization, ORS consumption during hospitalization,
and time laps of stool consistency conversion. The effectiveness
analysis was controlled for confounders.
Results Supplementation of 0.5 gram GA to 200 ml ORS could decrease
the duration of diarrhoea 15.65 hours (P=0.000) during hospitalisation,
frequency of defecation during hospitalization 1.171 times/days
(P=0.002), ORS consumption 38.39 ml/kg BW (P=0.029), time of
stool consistency to become semisolid 15.84 hours (P=0.000), and
become solid 14.45 hours (P=0.002). Vomiting during hospitalization
and aged group of 6-11 months were significant confounder. However,
after controlling the outcome with these confounding factors, the
benefits of GA supplementation were still significant.
Conclusions GA supplementation to ORS significantly shorten
the duration of diarrhea, decreases the frequency of defecation,
consumption of ORS, time of stool consistency to become
semisolid and solid in inpatients diarrheal cases.
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metabolism and calorific value. Food Addit Contam
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infections. J Pediatr Gastroenterol Nutr;39:239-45.
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blood lipids in humans. J Am Coll Nutr 1993;12:147-54.
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jalan. Palembang: Bagian IKA FK UNSRI/RSMH; 2006.
Jakarta: DepKes RI Ditjen PPM & PLP; 1990. p. 1-164.
2. Wapnir RA. Recent progress and future aims in the
formulation and use of oral rehydration solution. Int Pediatr
2000;15:205-14.
3. Soeparto P, Djupri LS, Sudarmo SM, Ranuh IGM RG.
Gangguan absorpsi sekresi sindroma diare. Surabaya:
GRAMIK FK Unair; 1999. p. 1-153.
4. Murphy MS. Guidelines for managing acute gastroenteritis
based on a systemic review of published research. Arch Dis
Child 1998;79:179-84.
5. Guandalini S. The treatment of acute diarrhea in the third
millennium: a pediatrician’s perspective. Acta Gastroenterol
Belg 2002;65:33-6.
6. Wapnir RA, Wingertzahn MA, Moyse J, Teichberg S. Gum
arabic promotes rat yeyunal sodium and water absorpsion
from oral rehydration solutions in two models of diarrhea.
Gastroenterology 1997;112:1979-85.
7. Teichberg S, Wingertzahn MA, Moyse J, Wapnir RA. Effects
of gum arabic in an oral rehidration solution on recovery
from diarrhea in rats. J Pediatr Gastroenterol Nutr
1999;29:411-7.
8. Wapnir RA, Teichberg S, Go JT, Wingertzahn MA, Harper
RG. Oral rehydration solutions: enhanced sodium absorption
with gum arabic. J Am Coll Nutr 1996;15:377-82.
9. Phillips GO. Acacia gum (gum arabic): a nutritional fibre;
metabolism and calorific value. Food Addit Contam
1998;15:251-64.
10. Anonym. Gum Arabic. Available from http://www.gased.it
11. National Toxicology Program. NTP techical report on the
carcinogenesis bioassay of gum arabic (CAS No. 9000-01-5) in
F344 rats and B6C3F1 mice (feed study). North Carolina: US
Departement of Health and Human Service; 1982.p.1-55.
12. International programme on chemical on chemical safety
WHO. Toxicological evaluation of some food colours,
emulsifiers, stabilizers, anti-caking agent and certain other
subtances. FAO Nutrion Meetings Report Series No. 46A
WHO/FOOD ADDD/70.36.
13. Anonym. Gummi arabicum. Farmakope. 5 th ed.p. 278-9.
14. Bliss DZ, Stein TP, Schleifer CR, Settle RG. Suplementation
with gum arabic fiber increases fecal nitrogen excreation and
lowers serum urea nitrogen concentration in chronic renal
failure patients consuming a low-protein diet. Am J Clin Nutr
1996; 63:392-8.
15. Jensen CD, Spiller, Gate JE, Miller AF, Whittam. The effect
of acacia gum and a water soluble dietary fiber mixture on
blood lipids in humans. J Am Coll Nutr 1993;12:147-54.
16. Ross AH, Easwood MA, Brydon WG, Anderson JR,
Anderson DM. A study of the effects of dietary gum arabic
in humans. Am J Clin Nutr 1983;37:368-75.
17. Phillips GO. Acacia gum (gum arabic): a nutritional fibre,
metabolism and calorific value. Food Addit Contam
1998;15:251-64.
18. Alam NH, Meier R, Schneider H, Sarker SA, Bardhan PK,
Mahalanabis D, et al. Partially hydrolyzed guar gum-
supplemented oral rehydration solution in the treatment of
acute diarrhea in children. J Pediatr Gastroenterol Nutr
2000;31:499-502.
19. Ramakrhrisna BS, Venkataraman S, Srinivasan P, Dash P,
Young GP, dan Binder HJ. Amylase-resistant starch plus ors
for cholera. N Eng J Med 2000;342:308-13.
20. Hoekstra JH, Szajewska H, Zikri MA, Micetic-Turk D, Weizman
Z, Papadopoulou A, et al. Oral rehydration solution containing
a mixture of non-digestible carbohydrates in the treatment of
acute diarrhea: a multicenter randomized placebo controlled
study on behalf of the ESPGHAN working group on intestinal
infections. J Pediatr Gastroenterol Nutr;39:239-45.
21. Jensen CD, Spiller, Gate JE, Miller AF, Whittam. The effect
of acacia gum and a water soluble dietary fiber mixture on
blood lipids in humans. J Am Coll Nutr 1993;12:147-54.
22. Marsintauli HS. Manfaat penambahan gum arabik terhadap
efektifitas oralit pada pengobatan diare akut penderita rawat
jalan. Palembang: Bagian IKA FK UNSRI/RSMH; 2006.
Published
2016-09-24
How to Cite
1.
Salwan H, Isnada I, Bakri A, Ismail R, Bahar E. Benefits of gum arabic supplementation to oral rehydration solution in managing acute diarrhea. PI [Internet]. 24Sep.2016 [cited 3Jul.2024];47(6):265-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/430
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Received 2016-09-02
Accepted 2016-09-02
Published 2016-09-24
Accepted 2016-09-02
Published 2016-09-24
