Clinical studies in persistent diarrhea: Dietary management with green banana or pectin in Bangladeshi children

Background & Aims: 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. Methods: In a double-blind trial, 62 boys, age 5-12 months, were randomly given a rice-based diet containing ei ther 250 g/L of cooked green banana (n = 22) or 4 g/kg pectin (n = 19) or t he rice-diet alone (control, n = 21), providing 54 kcal/dL daily for 7 days . Stool weight and consistency, frequency of vomiting and purging, and dura tion of illness were measured. Results: Most children (60%) had no pathogen s isolated from stools, 17% had rotavirus, 5% Vibrio cholerae, 4% Salmonell a group B, and 11% had enterotoxigenic Escherichia coli infections. By day 3 posttreatment, significantly (P < 0.001) more children recovered from dia rrhea receiving pectin or banana than controls (59%, 55%, and 15%, respecti vely). By day 4, these proportions correspondingly increased to 82%, 78%, a nd 23%, respectively, the study diet groups being significantly (P < 0.001) different than controls. Green banana and pectin significantly (P <less th an> 0.05) reduced amounts of stool, oral rehydration solution, intravenous fluid, and numbers of vomiting, and diarrheal duration. Conclusions: Green banana and pectin are useful in the dietary management of persistent diarrh ea in hospitalized children and may also be useful to treat children at hom e.