Childhood diarrhoea is one of the leading health problems especially in low- and middle-income countries (LMICs), and accounts for many deaths, particularly in sub-Saharan Africa and Southeast Asia.
The World Health Organisation (WHO) recommended oral rehydration solution (ORS) and oral zinc therapy in addition to frequent breastfeeding and home-available fluids are the mainstay of management of diarrhoea.
Although ORS is credited with saving millions of lives by correcting dehydration, it does not impact the reduction of diarrhoea duration. However, zinc has already been shown to reduce diarrhoeal duration and hospitalisation.
Researchers in a review of current evidence of the effect of green banana consumption as a complement to standard treatment for acute or persistent diarrhoea said that it is associated with better recovery, aids in treating persistent diarrhoea, and involves less hospitalisation. It also reduces future episodes of diarrhoea.
A meta-analysis was performed to compare the effect of green bananas on the resolution of acute and persistent diarrhoea. Nine randomised controlled trials (seven open and two blinded) were included.
These were studies conducted in the paediatric population comprising a total of 3,996 patients aged eight to 34 months. Only randomised controlled trials using green bananas as an intervention were included, and studies using antidiarrheal medication were excluded.
The duration of diarrhoea, the proportion of children recovered, the requirement of hospitalisation, the development of persistent diarrhoea, and the number of diarrhoeal episodes in a obne=1-year follow-up period were considered.
Whole fruits were cooked in boiling water for 10 minutes with the skin intact, then cooled and peeled off, and the pulp taken out. The amount to be given and the frequency of feeding varied by the age of the child; it can be given as a paste-like suspension in young children or as fried chops or just boiled (mash) in older children 3–4 times a day with rice or other foods.
In the Indian Paediatrics journal, the proportion of children who recovered within 72 hours was significantly higher in the green banana group compared to the control group, and the number of children with complications such as dehydration and persistent diarrhoea was also significantly less in the intervention group.
Supplementation of cooked green bananas in the diet of children with acute watery diarrhoea with no dehydration hastens their recovery.
A trial was conducted among 2,968 Bangladeshi rural children 6–36 months old who were randomly assigned to either a standard care group or a standard care plus green banana group, where mothers were instructed to add cooked green banana to the diets of diarrhoeal children.
The community-based trial published in the Tropical Medicine and International Health reported that a green banana-supplemented diet hastened the recovery of acute and prolonged childhood diarrhoea managed at home in rural Bangladesh.
The recovery rates of children with acute diarrhoea receiving green banana were significantly higher by day 3. Children with prolonged diarrhoea receiving green bananas had significantly higher recovery rates by day 10.
This finding has important clinical implications since major infective diarrhoeas (cholera, Escherichia coli, rotavirus diarrhoeas) are usually of rapid onset and short duration (three to five days).
The antidiarrheal action of green bananas is thought to be mediated by their high content of amylase-resistant starch that, upon reaching the colon, is fermented into short-chain fatty acids, in turn stimulating colonic salt and water absorption.
At present, oral rehydration solution (ORS) remains the mainstay of home management of diarrhoea. However, ORS alone does not visibly reduce stool volume, and its utilisation rates still remain below 30 percent in many developing countries.
Where green bananas are available, they have the potential to be an effective therapeutic adjunct to ORS. Supplementing the green banana diet with other effective antidiarrheal agents, including zinc as recommended by WHO and UNICEF, may increase its therapeutic potential by synergistic actions.
Also, more clinical trials are necessary to assess if a synergistic effect between green bananas and other foods exists and proves to be better than green bananas alone. These findings need to be confirmed in diverse socioeconomic contexts, within the adult population, and under varying health conditions.
Meanwhile, several cereal-based (rice, oatmeal, semolina, banana) and chicken-based diets are clinically useful in the management of childhood diarrhoea, and the antidiarrhoeal effects of dietary fibre in children have also been reported.
Fermented milk, rice water, lemongrass tea, and complex starches such as hydrolysed guar gum also showed antidiarrheal effects in preliminary trials, which need further evaluation.
In most communities in the southwest of Nigeria, uncooked “ogi” slurry, a Nigerian fermented food made from cereal grains such as maize, is normally used traditionally for relieving stomach discomfort and diarrhoea by the rural people. The presence of lactobacilli in the slurry was reported to be responsible for its antidiarrheal effect.
It may be best to avoid some dairy products during episodes of diarrhoea, but not all. Certain fermented dairy foods with live probiotic bacteria—like yoghurt or kefir—are extremely beneficial.
READ ALSO: 10 home remedies for diarrhoea
and then