1203 Low Viscosity Soluble Dietary Fibre for Gastroparesis Sufferers

Abstract

INTRODUCTION: Gastroparesis is a chronic idiopathic disorder which affects 125,000 people in Australia. The symptoms of gastroparesis can range from mild to very severe. Current management of gastroparesis involves enteral strategies such as prescription drugs, feeding tubes using jejunostomy and gastric electric simulation (GES). Medical practitioners currently recommend that gastroparesis sufferers take little to no fibre in their diet regardless of the severity of their symptoms but low-viscosity soluble fibres have been proposed as a solution for dietary fibre intake in mild to moderate gastroparesis sufferers. METHODS: The rheological properties of ten soluble dietary fibres were studied under normal and simulated gastric conditions. A clinical trial involving two soluble fibres (test fibres), one partially-soluble fibre (positive control) and no fibre (negative control) was approved under the UID H12254 at Western Sydney University, AUS. The clinical trial is used to study blood glucose absorption, symptoms and mouth-to-caecum emptying times of eligible patients after consumption of soluble dietary fibres under controlled conditions. The polysaccharide chain length and monosaccharide unit composition in these dietary fibres will be analysed using Q-ToF-MS. RESULTS: The rheological stress σ (Pa) at the visco-elastic relaxation modulus Gc under normal and simulated gastric conditions was characterised for 10 different fibres. There was a significant reduction in the rheological stress from normal to gastric conditions for three low-stress soluble fibres. Two of those three low-stress fibres and one medium-stress fibre were selected for the clinical trial. Preliminary results of the clinical trial (6 patients) indicate that most patients find the low-stress fibres more palatable than the medium-stress fibre based on the Gastroparesis Cardinal symptom Index (GCSI). No significant differences in postprandial blood glucose absorption over 3 hours were observed for both the low-stress and medium-stress fibres. The low-stress fibres also show no significant delay in gastric emptying up to 3 hours compared to the negative control using hydrogen breath test analysis. CONCLUSION: The preliminary results of the rheology and the clinical trial indicate that soluble fibres could be incorporated into the diet of a gastroparesis patient. We hope to summarize the rheological, chemical and clinical data about these fibres and provide the relevant information to dieticians and gastroenterologists.