JP2002308780A - Defecation frequency-improving agent or defecation frequency-improving food - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a defecation frequency-improving agent or defecation frequency-improving food for decreasing the number of defecations in inflammatory bowel diseases such as malabsorption syndrome, Crohn disease(CD), short bowel syndrome, etc. SOLUTION: This defecation frequency-improving agent or defecation frequency-improving food is developed on the basis that it was elucidated that the improvement of the number of defections is possible by adding starch into an elemental diet in performing HEN, and provided by incorporating the starch as an active ingredient and preferably being administered into a jejunum through a tube by adding the starch to the elemental diet.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

TECHNICAL FIELD The present invention relates to malabsorption syndrome,
The present invention relates to an agent or food for improving the number of bowel movements at the time of HEN administration of an ingredient nutrient (ED) performed for patients with inflammatory bowel disease such as Crohn's disease (CD) and short bowel syndrome.

[0002]

2. Description of the Related Art Nutrition therapy (EN) using component nutrients (ED) and semi-digestive nutrients is a treatment for patients with inflammatory bowel disease such as malabsorption syndrome, Crohn's disease (CD), and short bowel syndrome. Useful. In these diseases, especially HEN
Has been done. In the exacerbation period of these inflammatory bowel diseases, osmotic diarrhea due to nutrients and shortening of the transit time of the intestinal tract are added, and the number of bowel movements is further increased. In addition, CD frequently occurs in the ileocecal area, and often causes an increase in the number of stools due to a decrease in bile acid absorption and an increase in damage to the terminal ileum due to ileocecal resection. For these symptoms, administration of antidiarrheal agents, intestinal motility inhibitors, water-soluble dietary fiber, pectin, anion-exchange resin, etc. has been performed so far, and good results have been obtained in some cases. There is a need for new countermeasures.

[0003] On the other hand, carbohydrates are generally classified into carbohydrates and dietary fiber, and carbohydrates are used as nutrients in normal dietary intake. However, dietary fiber is not digested by human digestive enzymes. Is not a nutrient. Starch is a carbohydrate and is a huge molecule composed of an amylose moiety in which glucose is linearly linked by α1,4 bonds and amylopectin in which glucose is linked by α1,6 bonds in a branched manner. When taken orally, it is rapidly hydrolyzed to glucose by salivary amylase and pancreatic amylase and absorbed. Dietary fiber has not been used in the past because it is not digested by human digestive enzymes.However, recent advances in nutrition have made it possible for nutrients to function as a function of dietary fiber. Other features are attracting attention. Thus, nutritionally, dietary fiber and carbohydrate are recognized as substances whose actions are completely different.

[0004]

DISCLOSURE OF THE INVENTION As described above, the present inventors have studied the problem of increased defecation frequency in inflammatory bowel diseases such as malabsorption syndrome, Crohn's disease (CD), and short bowel syndrome. In order to provide a defecation frequency improving agent or a defecation frequency improving food, various substances were discussed from new findings obtained through basic research and clinical tests.

[0005]

[Means for Solving the Problems] As a result, when HEN is performed in inflammatory bowel diseases such as malabsorption syndrome, Crohn's disease (CD), and short bowel syndrome, the number of defecations can be increased by adding starch to a component nutrient. It has been clarified that the number of bowels can be improved, that is, the number of bowel movements can be reduced. That is, the present invention
The present invention relates to a defecation frequency improving agent or a defecation frequency improving food containing starch as an active ingredient.

[0006]

BEST MODE FOR CARRYING OUT THE INVENTION The present invention is a defecation frequency improving agent or defecation frequency improving food comprising starch as an active ingredient. The defecation frequency improving agent or defecation frequency improving food of the present invention is mainly used for improving defecation frequency in inflammatory bowel diseases such as malabsorption syndrome, Crohn's disease (CD), and short bowel syndrome. In these patients, HEN is usually administered by adding starch to an ingredient nutrient (ED), but it is also possible to separately administer starch alone.

[0007] The starch used in the present invention may be a modified starch or a food-derived starch.
Usually, it has a gelatinization property. The dosage of starch is preferably about 1 g to 30 g per day. Normally, at the time of HEN, 0.1% to 3.0% (w /
Preferably, the starch of v) is added and administered daily. Within the range of 0.1% to 3.0%, although the viscosity of the nutrient solution is increased by the addition of starch to form a gel, a sufficient flow rate can be obtained for HEN using a pump, and there is no problem.

[0008] The present invention is also described as a nutrient composition characterized in that starch is added to a component nutrient as a defecation frequency improving agent. In this case, the amount of added starch is preferably about 0.3% to 11% (w / w) based on the component nutrient. In addition, component nutrients are high-energy, high-nitrogen-containing pharmaceutical diets in which all nutrients are composed only of those with a scientifically clear composition.The nitrogen source uses amino acids, and the sugars use dextrin. It is a digestive nutritional supplement that has an extremely low fat content and is appropriately blended with vitamins, electrolytes and trace elements.

In the method of administering starch or a component nutrient to which starch is added according to the present invention, HEN in inflammatory bowel diseases such as malabsorption syndrome, Crohn's disease (CD) and short bowel syndrome is usually used in a tube. Since the distal end is placed in the jejunum, it is considered preferable to administer to the jejunum by tubing in order to achieve the effect of improving the number of defecations. This is one theory, but when starch is administered to the jejunum, the starch will not be subject to enzymatic degradation by salivary amylase or pancreatic amylase, which would inevitably occur in the normal way of ingestion. It may be related to the onset of the number-of-times improving effect.

[0010] To further explain the difficulty of the present invention, the component nutrient (ED) contains dextrin, which is a carbohydrate, and usually, the meaning of adding starch, which is the same carbohydrate nutritionally, is significant. It is thought that there is not. Also, HE
In N, a component nutrient (ED) is administered little by little from a thin enteral feeding tube using a pump. Therefore, the addition of starch to an ingredient nutrient (ED) has the disadvantage of increasing the viscosity and deteriorating the flowability of the tube, and is usually inconceivable.

[0011]

EXAMPLES Test Example 1 Method: Elenthal (Ajinomoto Pharma), an ingredient nutrient (ED), is dissolved in water, and starch or tromeline granules (Sanwa Chemical Laboratory: mainly composed of starch) are added, respectively. 1.0kcal / m as Elental
l, 0.5% (w / v), 1.0% (w
/ v), 2.0% (w / v), 3.0% (w / v), 4.0% (w / v), and 5.0% (w / v). Put the nutrient solution into an enteral feeding bag, connect a 5 Fr. tube feeding tube, set in a renter system (enteral feeding pump), operate the pump at a flow rate of 50 ml / h. The amount was measured for 2 hours.

Results: The amounts and properties of starch or tromerin granules flowing down at each concentration were as follows. As a result, in order for the elental 1.0 kcal / ml solution to which starch or tromelin granules have been added to flow down by the Frenta system (enteral feeding pump) at a pump setting of 50 ml / h. The starch concentration had to be at most 3.0% or less. At a concentration of 5.0%, the viscosity was increased by the starch or tromerin granules, and reproducibility such as an error in the pump system was not obtained, and it was difficult to pass through the tube. Incidentally, starch and tromelin granules obtained almost the same results.

[0013]

[Table 1]

Test Example 2 (Clinical test) Method: The subjects were 15 CDs (9 males, 6 females) during HEN
Cases, average age 30.6 ± 7.7 years), the number of stools is more than 5 lines / day, the disease type is 2 small intestine type, 11 small intestine large intestine type, 2 large intestine type. 11 cases. A solution of Elenthal (Ajinomoto Pharma), a component nutrient (ED), so that starch or tromelin granules have a 0.5% concentration (1.0 kca
l / ml) and nasal enteral feeding to the jejunum was performed. The administration was carried out every day, and the daily dose was 28.6 ± 4.4 kcal / kg-body weight / kg body weight as the calorific value of the component nutrient, and 0.143 g / kg as starch. The number of bowel movements, inflammation index, and nutrition index were measured before administration, 4 weeks after administration, and 8 weeks after administration, and clinical evaluation was performed. Administration was discontinued if it was determined that continuation was difficult during treatment.

Results: In 10 out of 15 cases (66.7%), the number of stools decreased and the amount of stools increased, and CRP, an index of inflammation, tended to decrease, but the values before administration varied. And no significant difference was obtained (a significant difference was found at a risk rate of 5% between 4 weeks and 8 weeks). There was no effect on nutritional indicators. Due to the increase in stool volume, the time for consent is prolonged,
The number of night flights decreased. Five of the 15 patients were ineffective, 3 of them had no change in defecation frequency, and the other 2 discontinued treatment due to abdominal distention. Table 2 shows the results of the clinical evaluation.

[0016]

[Table 2]

[0017]

EFFECT OF THE INVENTION Particularly, malabsorption syndrome, Crohn's disease (C
D), in patients with inflammatory bowel diseases such as short bowel syndrome, etc., the effect of improving the number of defecations is obtained.

Continued on front page F-term (reference) 4B018 MD34 ME11 4C084 AA19 MA02 MA52 MA60 NA05 NA14 ZA66 4C086 AA01 AA02 EA20 MA01 MA02 MA04 ZA66 ZC22

Claims (4)

[Claims] 1. A defecation frequency improving agent or a defecation frequency improving food comprising starch as an active ingredient. 2. The defecation frequency-improving agent or defecation frequency-improving food according to claim 1, wherein the agent is administered to the patient with inflammatory bowel disease by intestinal administration. 3. The defecation frequency improving agent or defecation frequency improving food according to claim 1, wherein the agent is added to a component nutrient when HEN is performed. 4. A nutrient composition, wherein starch is added to the component nutrient as a defecation frequency improving agent.