tannins and Gastroenteritis

To determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children.. Systematic review and meta-analysis.. MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions.. Randomised controlled trials in children with ADG, comparing GT with placebo.. Of 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=-15.85 hours; 95% CI -42.24 to 14.82, I. The effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty).. CRD42018087902.

Topics: Acute Disease; Child; Diarrhea; Gastroenteritis; Gelatin; Humans; Tannins; Treatment Outcome

Intestinal permeability impairment is implicated in many gastrointestinal (GI) diseases. Chronic diarrhea, defined as the presence of diarrhea for more than 3 weeks in adults and 2 weeks in children, requires a different diagnostic and therapeutic work-up than acute diarrhea. Gelatin tannate, by reducing the clinical activity of acute colitis and the proinflammatory effects of lipopolysaccharide (LPS), is emerging as a mucosal barrier protector.. New therapeutic strategies focusing on the physiological function of the intestinal barrier, may offer an innovative approach for the clinical improvement of highly debilitating chronic GI diseases. We review the available data on the role of gelatin tannate and tyndallized probiotics in the treatment of diarrhea.. Gelatin tannate and tyndallized probiotics can be used to re-establish the physiological functions of the gut barrier, as well as for preventing dysbiosis. There is evidence that due to their particular properties, gelatin tannate and tyndallized probiotics are highly effective in the treatment of acute gastroenteritis and may be especially indicated in the management of moderate and prolonged diarrhea.. Gelatin tannate and tyndallized probiotics may be effective in the management of chronic diarrhea. Further clinical trials are necessary to further explore their effects in clinical practice.

Topics: Diarrhea; Gastroenteritis; Gastrointestinal Diseases; Gelatin; Humans; Probiotics; Tannins

Most clinical problems due to plant exposures result from experimentation with or overt abuse of plant parts and extracts. Plant exposures may present as complex pharmacologic problems that challenge the diagnostic and therapeutic skills of the physician. Although specific physiologic antagonists (antidotes) may exist for specific intoxications, basic decontamination and supportive techniques are often all that may be offered.

Topics: Adult; Alkaloids; Autonomic Nervous System Diseases; Cardiovascular Diseases; Central Nervous System Diseases; Child; Child, Preschool; Dermatitis, Contact; Emergencies; Gastroenteritis; Glycosides; Hematologic Diseases; Humans; Kidney Diseases; Liver Diseases; Magnoliopsida; Oils; Plant Extracts; Plant Poisoning; Plants, Toxic; Resins, Plant; Tannins

Exposures to plants generate an exceptional amount of public concern, especially plant ingestions by children. Most clinical problems, however, involve older age groups as a result of experimentation with or overt abuse of plant parts and extracts. Of mounting concern is the sometimes uninformed and massive use of herbal preparations, currently widely available and in popular vogue. Plant exposures, from whatever source, may present as complex pharmacologic problems that may challenge the diagnostic and therapeutic skills of the physician. Although specific physiologic antagonists (antidotes) may exist for specific intoxications, basic decontamination and supportive techniques are many times all that may be offered.

Topics: Adult; Alkaloids; Cardiovascular Diseases; Child; Cyanides; Dermatitis, Contact; Emergencies; Female; Gastroenteritis; Glycosides; Hematologic Diseases; Humans; Kidney Diseases; Liver Diseases; Magnoliopsida; Male; Mouth Mucosa; Nervous System Diseases; Oils, Volatile; Plant Poisoning; Plants, Edible; Plants, Medicinal; Plants, Toxic; Resins, Plant; Tannins

To assess the efficacy of gelatine tannate (a complex of tannic acid with astringent and anti-inflammatory properties, and a protective gelatine) for the treatment of acute gastroenteritis (AGE) in children.. Randomised, double-blind, placebo-controlled trial. Intention-to-treat analysis.. Two paediatric hospitals in Warsaw.. Children younger than 5 years of age with AGE, defined as a change in stool consistency to a loose or liquid form (according to the Bristol Stool Form Scale or Amsterdam Stool Form Scale) and/or an increase in the frequency of evacuations (≥3 in 24 hours), lasting for no longer than 5 days.. Seventy-two children were assigned to receive gelatine tannate (n=36) or placebo (n=36) in addition to standard rehydration therapy. The gelatine tannate was administered at an age-dependent dose (250-500 mg), and both study products were taken four times per day for 5 days.. The main outcome measure was duration of diarrhoea. Secondary outcomes included the need for intravenous rehydration, need for hospitalisation of outpatients, number of watery stools per day, vomiting, weight gain, adverse events, recurrence of diarrhoea, severity of diarrhoea according to the Vesikari Scale and use of concomitant medications.. Sixty-four children (89%) completed the intervention and were included in the analysis. The duration of diarrhoea after randomisation was similar in the gelatine tannate and placebo groups (75.6±27.8 vs 75.5±29.0 hours, respectively, mean difference 0.1 hours, 95% CI -14.1 to 14.3 hours). There was no significant difference between groups in the number of watery stools per day throughout the study period. There were also no differences in any other secondary outcome measures between groups.. In children with AGE younger than 5 years of age, gelatine tannate was ineffective as an adjunct to rehydration therapy.. NCT02280759.

Topics: Acute Disease; Child, Preschool; Defecation; Diarrhea; Double-Blind Method; Feces; Female; Fluid Therapy; Gastroenteritis; Gelatin; Hospitalization; Humans; Infant; Intention to Treat Analysis; Male; Probiotics; Tannins; Treatment Outcome

AG is the most common cause of pediatric consultations among children between 2 and 5 years of age and it still leads to high mortality and morbidity. Its management is based on rehydration therapy, but this treatment is not effective in reducing duration of diarrhea. For this reason, other safer and less expensive interventions, which could be added to oral rehydration therapy, are of great interest.. A pilot, randomized, case-controlled trial was conducted in 60 children affected by AG (< 7 days) with mild-moderate dehydration, according to WHO recommendations, from1 year to 17 years old. Patients were divided into 2 Groups: Group 1 consisting of 30 children treated with Actitan F and standard oral rehydration (SOR); Group 2 consisting of 30 children who received only SOR. Both groups received treatment for seven days, respectively. Patients of Group 1 stopped for their own choice, SOR after the first 24 h and continued only with Actitan F.. After 24 h of treatment, the median number of stools was 3.5 for Group 1, and 4 for Group 2. In Group 1 the difference between the number of stools at baseline (n = 5) and after 24 h of treatment (n = 3.5) was significant (p < 0.0001). At the end of treatment, the median duration of diarrhea in Group 1 was 5 days, compared with 4 days in the Group 2, this difference was not statically significant (p 0.48).. Oral administration of Actitan F associated with SOR seems safe and effective treatment in shortening the duration of AG in children. Further studies confirming these data are needed.. NCT03356327 (retrospectively registered).

Topics: Acute Disease; Administration, Oral; Age Factors; Antidiarrheals; Case-Control Studies; Child; Child, Preschool; Dehydration; Diarrhea; Female; Flavonoids; Fluid Therapy; Follow-Up Studies; Gastroenteritis; Humans; Infant; Male; Pilot Projects; Risk Assessment; Tannins; Treatment Outcome

Gelatin tannate (GT) is a nonabsorbable antidiarrheal agent investigated in few clinical studies. The aim of this study was to investigate the effects of GT on children with acute gastroenteritis. This randomized, placebo-controlled, single-blinded, prospective study involved children aged from six months to 10 years with acute diarrhea. The study group received GT and the control group placebo for five days. Stool frequency and numbers of patients with diarrhea in each group were compared at 12, 24, 48, 72, 96, and 120 hours. Duration of diarrhea and weight changes after 120 hours was recorded. Mean stool frequency was lower in the study group at 0-12 hours (3±1.8 vs. 3.6±1.9, p=0.04). The study group exhibited more weight gain after 120 hours of treatment and shorter total duration of diarrhea, although the difference was not statistically significant. Fewer patients in the study group had diarrhea at the end of 12, 24, 96, and 120 hours. Patients treated with GT with Bristol scores of 7 at admission exhibited more weight gain than patients with Bristol scores of 6 (296±38 vs. 137±39, p=0.04). GT resulted in a decreased stool frequency at 12 hours in children with acute diarrhea. It shortened total duration of diarrhea and resulted in more weight gain compared to placebo. It also had a greater effect on weight gain in the presence of watery, rather than mushy stool.

Topics: Acute Disease; Antidiarrheals; Body Weight; Child; Child, Preschool; Diarrhea; Feces; Female; Gastroenteritis; Gelatin; Humans; Infant; Male; Prospective Studies; Single-Blind Method; Tannins; Treatment Outcome

Oral rehydration therapy is the recommended treatment for acute childhood gastroenteritis. The aim of this study was to assess the efficacy and safety of gelatin tannate plus oral rehydration compared with oral rehydration alone.. We conducted a multicenter, parallel, randomized, controlled, single-blind, prospective, open-label trial. A central randomization center used computer generated tables to allocate treatments. The study was performed in two medical centers in Italy. Sixty patients 3-72 months of age with acute gastroenteritis were recruited (median age 18 months; age range 3-66 months): 29 received an oral rehydration solution (ORS) and 31 an ORS plus gelatin tannate (ORS + G). The primary outcome was the number of bowel movements 48 and 72 h after initiating treatment. Secondary outcomes were: duration of diarrhea, stool characteristics and adverse events.. No patient was lost at follow-up. No significant difference in the number of bowel movements after 48 h was reported (2.7 ± 1.3 ORS + G; 3.2 ± 0.8 ORS; p = 0.06), although the ORS + G group showed a significant improvement in stool consistency (3.7 ± 1.0 vs. 4.3 ± 0.8; p = 0.005). At 72 h, a significant reduction in bowel movements was reported in the ORS + G group compared with the ORS group (1.0 ± 1.4 vs. 2.0 ± 1.7; p = 0.01). Mean duration of diarrhea was significantly lower in the ORS + G group than in the ORS only group (76.8 ± 19.2 vs. 108 ± 24.0 h; p < 0.0001). No adverse events were reported.. Gelatin tannate added to oral rehydration in children with acute diarrhea was associated with a significant decrease in bowel movements at 72 h, with an early improvement in the stool consistency and shorter disease duration.. NCT02644200-Gelatin Tannate as Treatment for Acute Childhood Gastroenteritis ( https://www.clinicaltrials.gov ).

Topics: Acute Disease; Child, Preschool; Diarrhea; Female; Fluid Therapy; Gastroenteritis; Gelatin; Humans; Infant; Male; Prospective Studies; Single-Blind Method; Tannins; Treatment Outcome

Worldwide, acute gastroenteritis in children, usually caused by viruses, leads to considerable morbidity and mortality. The treatment is aimed at preventing and treating dehydration, promoting weight gain after rehydration, and reducing the duration and severity of diarrhoea. Effective and inexpensive interventions that could add to the effect of oral rehydration therapy are of interest. Recently, in many European countries, gelatine tannate is being widely marketed for treating acute gastroenteritis. Gelatine tannate is a complex of tannic acid, which possesses astringent and anti-inflammatory properties, and a protective gelatine. Currently, there is no evidence to support the use of gelatine tannate for treating acute gastroenteritis in children and only scant evidence to support the use of gelatine tannate in adults. We aim to assess the efficacy of gelatine tannate for the treatment of acute gastroenteritis in children.. This will be a blind, placebo-controlled, randomised trial. Children younger than 5 years of age with acute gastroenteritis defined as a change in stool consistency to loose or liquid form (according to the Bristol Stool Form scale or Amsterdam Stool Form scale) and/or an increase in the frequency of evacuations (typically ≥ 3 in 24 h), lasting for no longer than 5 days, will be recruited. A total of 72 children will be randomised to receive either gelatine tannate (children younger than 3 years of age will receive 250 mg, 4 times/day, and those older than 3 years of age will receive 500 mg, 4 times/day) or matching placebo for 5 days. The primary outcome measure is the duration of diarrhoea.. The Bioethics Committee approved the study protocol. The findings of this trial will be submitted to a peer-reviewed paediatric journal. Abstracts will be submitted to relevant national and international conferences.. NCT02280759; Pre-results.

Topics: Acute Disease; Child, Preschool; Europe; Gastroenteritis; Gelatin; Humans; Research Design; Single-Blind Method; Tannins; Treatment Outcome

To evaluate the effectiveness and safety of gelatin tannate (GT) for acute gastroenteritis (AGE) in children.. In this retrospective, observational study, children admitted for AGE received GT ± oral rehydration solution (ORS; n = 46) or other antidiarrheal medications ± ORS (n = 46). Number and consistency of stools were recorded.. Children were aged 6 months to 7.9 years. GT ± ORS reduced diarrhea duration (29.0 vs 45.4 h, p < 0.0001) and normalized stool consistency at 72 h in significantly more patients (87.0 vs 30.4%; p = 0.026) compared with other antidiarrheal medications ± ORS. Differences in favor of GT were apparent from 12 h onward.. GT is more effective than conventional treatment for managing AGE in children.

Topics: Acute Disease; Antidiarrheals; Child; Child, Preschool; Diarrhea; Female; Gastroenteritis; Gelatin; Humans; Infant; Male; Retrospective Studies; Romania; Tannins; Treatment Outcome

Human noroviruses (NoVs) are the leading cause of gastroenteritis and foodborne illnesses worldwide. In this study, we investigated the effects of persimmon extract (PE) on NoV GII.4 and bacteriophage MS2. We also examined the relationship between the tannin content of PE and its antiviral effects to identify the active ingredient in PE. Different persimmon tannin (PT) solutions were prepared by mixing PE with different concentrations of bovine serum albumin. The antiviral efficacy of these solutions against NoV was evaluated by quantifying the amount of residual noroviral genome using a quantitative reverse transcription PCR (qRT-PCR) assay. The antiviral efficacy of PE against MS2 was examined with an infectivity assay (plaque assay). Solutions containing ≥ 0.11 mg/mL PT reduced the noroviral genome by more than 70.0% and the infectivity of MS2 by more than 2.5 log PFU/mL. However, the effects of PT on both viruses decreased markedly at a concentration of 0.08 mg/mL and solutions containing negligible PT had no antiviral activity. These results suggest that the PT component of PE inactivates NoV and MS2. Our results indicate that PE is a nontoxic antiviral agent effective against enteric viruses.. Persimmon extract showed antiviral effects against NoV and bacteriophage MS2. Persimmon extract is suitable for use as an antiviral agent.

Topics: Antiviral Agents; Caliciviridae Infections; Cell Line; Diospyros; Foodborne Diseases; Gastroenteritis; Humans; Levivirus; Norovirus; Plant Extracts; Tannins; Viral Plaque Assay

Topics: Animals; Animals, Newborn; Cattle; Cattle Diseases; Escherichia coli Infections; Gastroenteritis; Gels; Pepsin A; Sulfamethazine; Tannins

The LD(50) +/- S.E. of tannic acid given orally to albino rats was found to be 2.26+/-0.083 g. per kg. body weight, which is higher than its apparent LD(50) when given per rectum. The immediate cause of death was respiratory failure preceded by convulsions when death occurred early and by hypothermic cachexia when death was delayed. Death was associated with a progressively developing hepatic necrosis and nephritis and a temporary acute gastroenteritis. It was accompanied by loss of weight and edema in many organs, evidence of stimulation of the spleen, adrenal cortex and testes, and atrophy of the thymus. Recovery in survivors was associated with a temporary increase in weight of the spleen and testes and persistence of loss of weight in the adrenal, pyloric stomach, and skin.

Topics: Cachexia; Chemical and Drug Induced Liver Injury; Edema; Gastroenteritis; Hepatitis; Hepatitis A; Hypothermia; Liver Diseases; Nephritis; Pathology; Rats; Research; Seizures; Spleen; Tannins; Toxicology

Topics: Cholecystitis; Gastroenteritis; Humans; Hydrolyzable Tannins; Mucous Membrane; Peptic Ulcer; Silver Proteins; Tannins