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Starch with high resistance to amylase to reduce stool output in people with short bowel syndrome: an experimental study


Short bowel syndrome (SBS) is defined as having less than 200 cm of functional small intestine. It is difficult to cope with malabsorption diarrhea and dehydration, despite drug therapy and dietary manipulations.

Evidence suggests that adding high-amylose starch (HARS) to your diet can reduce diarrhea for a number of reasons, including gastroenteritis. HARS is expected to reduce stool production through the production of short chain fatty acids and, as a result, increased water reabsorption. This study was designed to determine whether the addition of HARS can reduce diarrhea in patients with SBS.


Continuously recruited SBS patients with a colon were recruited at the Austin Health intestinal rehabilitation clinic. The study was a two-week cross-test. Each participant underwent control and intervention (adding 50 g of HARS to a normal diet). The total daily stool mass and the number of intestinal effects per day were compared between groups using paired t-tests.


Eight adults (58% of men, mean age 55.7 years) were recruited. Five participants completed the test. The total daily stool mass was reduced in all participants by using HARS. The average daily rate of stool was significantly reduced from 1049 ± 519 g / day to 804 ± 585 g / day (p = 0.023). The number of bowel actions per day showed a downward trend.


This study provides some support for the hypothesis that adding HARS to the diet of patients with short bowel syndrome reduces stool output. Longer tests are required to confirm the effect on nutritional / wet conditions.

Hamilton K, Crowe T, Testro A.
Clin Nutr ESPEN. 2019 February; 29: 242−244
doi: 10.1016 / j.clnesp.2018.10.006.

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