pectins and Vomiting

To summarise the results from four clinical trials assessing the efficacy and safety of a thickening complex in the management of regurgitation in infants.. Infants (n = 392) younger than 5 months presenting with at least five regurgitations per day were recruited in four open-label, interventional, single-group, multi-centric clinical trials sharing an identical design. The efficacy of four different formulae thickened with different thickening complexes of pectin, starch and locust bean gum, was evaluated on regurgitation at days 3, 14 and 90, and stools and growth at days 14 and 90.. The daily number of regurgitation episodes was significantly reduced at days 3 and 14 vs baseline in all studies (P < .001), with the largest decrease with the formula having the highest pectin content (study 1; P < .001). In all studies, growth was within normal range. A trend towards stool normalisation for consistency was observed in three studies at day 90 vs baseline and was significant in study 1 (P < .001). Stool frequency was unchanged by the interventions.. The four tested thickened formulae reduced regurgitation and were proven to be safe. The formula with the largest amount of pectin and lowest starch content showed the best efficacy.

Topics: Gastroesophageal Reflux; Humans; Infant; Infant Formula; Pectins; Starch; Vomiting

The initial complications associated with infusion of enteral nutrition (EN) for clinical and nutritional care are vomiting, aspiration pneumonia, and diarrhea. There are many recommendations to prevent these complications. A novel method involving a viscosity-regulating pectin solution has been demonstrated. In Japan, this method along with the other so-called "semi-solid EN" approaches has been widely used in practice. However, there has been no randomized clinical trial to prove the efficiency and safety of a viscosity-regulating pectin solution in EN management. Therefore, we planned and initiated a multicenter randomized controlled trial to determine the efficiency and safety.. This study included 34 patients from 7 medical institutions who participated. Institutional review board (IRB) approval was obtained from all participating institutions. Patients who required EN management were enrolled and randomly assigned to the viscosity regulation of enteral feeding (VREF) group and control group. The VREF group (n = 15) was managed with the addition of a viscosity-regulating pectin solution. The control group (n = 12) was managed with conventional EN administration, usually in a gradual step-up method. Daily clinical symptoms of pneumonia, fever, vomiting, and diarrhea; defecation frequency; and stool form were observed in the 2 week trial period. The dose of EN and duration of infusion were also examined.. A favorable trend for clinical symptoms was noticed in the VREF group. No significant differences were observed in episodes of pneumonia, fever, vomiting, and diarrhea between the 2 groups. An apparent reduction in infusion duration and hardening of stool form were noted in the VREF group.. The novel method involving a viscosity-regulating pectin solution with EN administration can be clinically performed safely and efficiently, similar to the conventional method. Moreover, there were benefits, such as improvement in stool form, a short time for EN infusion, and a reduction in vomiting episodes, with the use of the novel method. This indicates some potential advantages in the quality of life among patients receiving this novel method.

Topics: Aged; Aged, 80 and over; Alanine Transaminase; Anthropometry; Aspartate Aminotransferases; Blood Cell Count; Blood Urea Nitrogen; C-Reactive Protein; Creatinine; Diarrhea; Enteral Nutrition; Female; Fever; gamma-Glutamyltransferase; Humans; Incidence; Japan; Leucyl Aminopeptidase; Male; Parenteral Nutrition Solutions; Pectins; Pneumonia; Prealbumin; Serum Albumin; Treatment Outcome; Viscosity; Vomiting; Zinc

The use of thickeners is a standard therapy for decreasing episodes of regurgitation or vomiting in infants. However, it remains to be investigated whether thickener is effective for vomiting and/or chronic respiratory symptoms in children with cerebral palsy.. We enrolled 18 neurologically impaired children caused by cerebral palsy, with gastroesophageal reflux disease. In the first part of this study (pH monitoring), subjects were randomly allocated to two groups: fed with a high-pectin diet [enteral formula: pectin liquid = 2:1 (v/v)], or a low-pectin diet [enteral formula: pectin liquid = 3:1 (v/v)]. Two-channel esophageal pH monitoring was performed over 48 h. In the second part (clinical trial), subjects were fed a high- or low-pectin diet and non-pectin diet for 4 weeks in a crossover manner. Nurses recorded the feeding volume, number of episodes of vomiting, volume of gastric residue, episodes of cough and wheeze, frequency of using oxygen for dyspnea, and the day when the child could return to school. Cough and wheeze were recorded as a cough-score.. The median value for the % time pH < 4 at the lower and upper esophagus was significantly decreased with a high-pectin diet [9.2% (6.2-22.6) vs. 5.0% (3.1-13.1); P < 0.01, 3.8% (2.9-11.2) vs. 1.6% (0.9-8.9); P < 0.01 (interquartile range), non-pectin and high-pectin, respectively]. The number of reflux episodes per day and duration of longest reflux were decreased significantly with a high-pectin, but not with a low-pectin diet. The median number of episodes of vomiting decreased significantly with a high-pectin diet [2.5/week (1.0-5.0) vs. 1.0 (1.0-1.5), P < 0.05]. The median cough-score was significantly decreased by both concentrations of pectin [8.5/week (1.0-11.5) vs. 2.0/week (0.0-3.0), fed with a high-pectin diet; 7.0/week (1.0-14.5) vs. 1.0/w (0.0-5.0), fed with a low-pectin diet, P < 0.05].. Pectin liquid partially decreased gastroesophageal reflux as measured by eshophageal pH monitoring, and might improve vomiting and respiratory symptoms in children with cerebral palsy.. ISRCTN19787793.

Topics: Adolescent; Antidiarrheals; Cerebral Palsy; Child; Cough; Cross-Over Studies; Dose-Response Relationship, Drug; Enteral Nutrition; Esophagus; Female; Food, Formulated; Gastroesophageal Reflux; Humans; Hydrogen-Ion Concentration; Male; Pectins; Prevalence; Vomiting

Because of the beneficial intestinal effects of dietary fibers, we have evaluated the therapeutic effects of green banana or pectin in children with persistent diarrhea.. In a double-blind trial, 62 boys, age 5-12 months, were randomly given a rice-based diet containing either 250 g/L of cooked green banana (n = 22) or 4 g/kg pectin (n = 19) or the rice-diet alone (control, n = 21), providing 54 kcal/dL daily for 7 days. Stool weight and consistency, frequency of vomiting and purging, and duration of illness were measured.. Most children (60%) had no pathogens isolated from stools, 17% had rotavirus, 5% Vibrio cholerae, 4% Salmonella group B, and 11% had enterotoxigenic Escherichia coli infections. By day 3 posttreatment, significantly (P < 0.001) more children recovered from diarrhea receiving pectin or banana than controls (59%, 55%, and 15%, respectively). By day 4, these proportions correspondingly increased to 82%, 78%, and 23%, respectively, the study diet groups being significantly (P < 0.001) different than controls. Green banana and pectin significantly (P < 0.05) reduced amounts of stool, oral rehydration solution, intravenous fluid, and numbers of vomiting, and diarrheal duration.. Green banana and pectin are useful in the dietary management of persistent diarrhea in hospitalized children and may also be useful to treat children at home.

Topics: Antidiarrheals; Bangladesh; Diarrhea, Infantile; Disease-Free Survival; Double-Blind Method; Feces; Fluid Therapy; Humans; Infant; Infusions, Intravenous; Male; Oryza; Pectins; Treatment Outcome; Vomiting; Zingiberales

The aim of this study was to formulate an easily-administered, safe and effective dosage form loaded with meclizine for treatment of chemotherapy-induced nausea and vomiting (CINV) through the buccal route. CINV comprises bothersome side effects accompanying cytotoxic drugs administration in cancer patients. Meclizine was loaded in chitosan-pectin nanoparticles which were further incorporated within a buccal film. Different formulations were prepared based on a 2

Topics: Administration, Buccal; Animals; Antiemetics; Antineoplastic Agents; Chemistry, Pharmaceutical; Chitosan; Cyclophosphamide; Cytokines; Delayed-Action Preparations; Drug Carriers; Drug Liberation; Humans; Hydrogen-Ion Concentration; Inflammation Mediators; Male; Meclizine; Microscopy, Electron, Transmission; Nanoparticles; Neurotransmitter Agents; Oral Mucosal Absorption; Pectins; Rats; Rats, Wistar; Sheep; Spectroscopy, Fourier Transform Infrared; Tensile Strength; Vomiting

We compared the effectiveness of 1 mM Geritol, 12% corn oil emulsion, Kaolin-pectin, single contrast oral barium sulfate, and effervescent granules as enteric magnetic resonance imaging (MRI) contrast agents. Five volunteers were recruited. Each volunteer ingested for examinations, separated by at least one week, either 500 ml of each of the liquid preparations or two packets of the CO2 granules (producing 400 ml of CO2 per packet). Abdominal MR images were then obtained using a 1.5 T Magnetom imager and SE 550/22, SE 2000/45/90 and FISP 40/18/40 degrees pulse sequences. The oil emulsions were best tolerated. Barium sulfate caused the greatest amount of nausea, followed by Geritol and Kaolin-pectin. With FISP 40/18/40 degrees, 60%-80% of the small bowel was well delineated using oil emulsion, Kaolin-pectin, or barium sulfate. We conclude that oil emulsion was by far the best enteric MR contrast agent in our study. Good delineation of the small bowel and pancreas can be achieved using oil emulsion and gradient echo pulse sequences. The lack of side-effects and the excellent taste make it highly acceptable to human subjects.

Topics: Abdominal Pain; Adult; Barium Sulfate; Carbon Dioxide; Colon; Contrast Media; Corn Oil; Defecation; Emulsions; Ferric Compounds; Humans; Image Enhancement; Intestine, Small; Intestines; Kaolin; Magnetic Resonance Imaging; Male; Nausea; Pancreas; Patient Satisfaction; Pectins; Quaternary Ammonium Compounds; Taste; Vomiting

Topics: Cellulose; Chemical Precipitation; Diagnosis, Differential; Female; Foreign Bodies; Gels; Humans; Infant; Infant Nutrition Disorders; Pectins; Radiography; Silicon Dioxide; Stomach; Stomach Neoplasms; Vomiting