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BMC Gastroenterology
Published in: BMC Gastroenterology 1/2020

Open Access 01-12-2020 | Ulcerative Colitis | Research article

The effects of resistant starches on inflammatory bowel disease in preclinical and clinical settings: a systematic review and meta-analysis

Authors: Joshua Montroy, Rania Berjawi, Manoj M. Lalu, Eyal Podolsky, Cayden Peixoto, Levent Sahin, Alain Stintzi, David Mack, Dean A. Fergusson

Published in: BMC Gastroenterology | Issue 1/2020

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Abstract

Background

Inflammatory bowel disease (IBD) is a debilitating chronic disease with limited treatment options. Resistant starches may represent a novel treatment for IBD. However, its efficacy and safety remain unclear. Our objective was to perform a systematic review to summarize the preclinical and clinical effects of resistant starch, which may help guide future studies.

Methods

Medline, EMBASE, and the Cochrane Central Register were searched. Included studies investigated the use of resistant starch therapy in in vivo animal models of IBD or human patients with IBD. Articles were screened, and data extracted, independently and in duplicate. The primary outcomes were clinical remission (clinical) and bowel mucosal damage (preclinical).

Results

21 preclinical (n = 989 animals) and seven clinical (n = 164 patients) studies met eligibility. Preclinically, resistant starch was associated with a significant reduction in bowel mucosal damage compared to placebo (standardized mean difference − 1.83, 95% CI − 2.45 to − 1.20). Clinically, five studies reported data on clinical remission but clinical and methodological heterogeneity precluded pooling. In all five, a positive effect was seen in patients who consumed resistant starch supplemented diets. The majority of studies in both the preclinical and clinical settings were at a high or unclear risk of bias due to poor methodological reporting.

Conclusions

Our review demonstrates that resistant starch is associated with reduced histology damage in animal studies, and improvements in clinical remission in IBD patients. These results need to be tempered by the risk of bias of included studies. Rigorously designed preclinical and clinical studies are warranted.
Trial registration
The review protocols were registered on PROSPERO (preclinical: CRD42019130896; clinical: CRD42019129513).
Appendix
Available only for authorised users
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Metadata
Title
The effects of resistant starches on inflammatory bowel disease in preclinical and clinical settings: a systematic review and meta-analysis
Authors
Joshua Montroy
Rania Berjawi
Manoj M. Lalu
Eyal Podolsky
Cayden Peixoto
Levent Sahin
Alain Stintzi
David Mack
Dean A. Fergusson
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2020
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-020-01516-4

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