Gelatin tannate versus other antidiarrheal medication in children with acute gastroenteritis: a retrospective, observational study

AIM

To evaluate the effectiveness and safety of gelatin tannate (GT) for acute gastroenteritis (AGE) in children.

MATERIALS & METHODS

In this retrospective, observational study, children admitted for AGE received GT ± oral rehydration solution (ORS; n = 46) or other antidiarrheal medications ± ORS (n = 46). Number and consistency of stools were recorded.

RESULTS

Children were aged 6 months to 7.9 years. GT ± ORS reduced diarrhea duration (29.0 vs 45.4 h, p < 0.0001) and normalized stool consistency at 72 h in significantly more patients (87.0 vs 30.4%; p = 0.026) compared with other antidiarrheal medications ± ORS. Differences in favor of GT were apparent from 12 h onward.

CONCLUSION

GT is more effective than conventional treatment for managing AGE in children.

The therapeutic effect of gelatin tannate in acute diarrhea in children

Gelatin tannate (GT) is a nonabsorbable antidiarrheal agent investigated in few clinical studies. The aim of this study was to investigate the effects of GT on children with acute gastroenteritis. This randomized, placebo-controlled, single-blinded, prospective study involved children aged from six months to 10 years with acute diarrhea. The study group received GT and the control group placebo for five days. Stool frequency and numbers of patients with diarrhea in each group were compared at 12, 24, 48, 72, 96, and 120 hours. Duration of diarrhea and weight changes after 120 hours was recorded. Mean stool frequency was lower in the study group at 0-12 hours (3±1.8 vs. 3.6±1.9, p=0.04). The study group exhibited more weight gain after 120 hours of treatment and shorter total duration of diarrhea, although the difference was not statistically significant. Fewer patients in the study group had diarrhea at the end of 12, 24, 96, and 120 hours. Patients treated with GT with Bristol scores of 7 at admission exhibited more weight gain than patients with Bristol scores of 6 (296±38 vs. 137±39, p=0.04). GT resulted in a decreased stool frequency at 12 hours in children with acute diarrhea. It shortened total duration of diarrhea and resulted in more weight gain compared to placebo. It also had a greater effect on weight gain in the presence of watery, rather than mushy stool.

Efficacy of gelatin tannate for acute diarrhea in children: a systematic review and meta-analysis

AIM

To investigate by meta-analysis the efficacy of gelatin tannate (GT), a mucosal barrier protector, in children with acute gastroenteritis.

METHODS

A comprehensive literature search was conducted. Studies were selected according to PICO: Participants: children aged 0-12 years with acute diarrhea; Intervention: GT; Comparison: oral rehydration solution and/or placebo; Outcomes: diarrhea-related outcomes.

RESULTS

Three published randomized controlled trials were identified of pediatric diarrhea treated with GT (n = 203) or control (n = 204). GT significantly (p < 0.01) reduced stool frequency at 12 h in two randomized controlled trials. A significant treatment effect (risk ratio = 0.74; p < 0.01) in favor of GT was found for the exploratory composite outcome of 'diarrhea or liquid stools at 24 h' in three studies. Risk ratios in a single study which reported the percentage of patients with liquid stools at 12, 24 and 48 h favored GT at all time points. No significant differences were found between GT and control for patients with diarrhea at 12 or 24 h or for duration of diarrhea.

CONCLUSION

GT improved stool frequency and stool consistency in children with acute diarrhea, although further well-controlled studies would be useful to confirm a beneficial treatment effect.

Protective efficacy of antidiarrheal agents in a permeability model of Escherichia coli-infected CacoGoblet® cells

AIM

To compare the protective efficacy of gelatine tannate/probiotic with other antidiarrheal agents in Escherichia coli-inoculated CacoGoblet^® cells.

METHODS

Four test compounds - gelatine tannate plus inactivated probiotic, diosmectite, probiotic mixture and Saccharomyces boulardii - were added to E. coli-infected CacoGoblet cells. After 1 and 24 h, transepithelial electrical resistance was measured and a lucifer yellow assay performed.

RESULTS

Gelatine tannate/probiotic markedly increased transepithelial electrical resistance by 123.1% (at 1 h) and 149.5% (at 24 h), and produced paracellular flux values of 0.41% (1 h) and 1.34% (24 h), which were considerably less than the E. coli-invasion value (2.41%).

CONCLUSION

The protective efficacy of gelatine tannate/probiotic against E. coli-induced reduction of membrane integrity manifests early and is maintained for 24 h.

Gelatin tannate ameliorates acute colitis in mice by reinforcing mucus layer and modulating gut microbiota composition: Emerging role for 'gut barrier protectors' in IBD?

BACKGROUND

Gelatin tannate, a gelatin powder containing tannic acids, is commonly employed as an intestinal astringent. Neither information nor animal model exist to confirm its efficacy or unravel mechanisms of action.

OBJECTIVE

To evaluate the action of gelatin tannate in murine dextran sodium sulphate (DSS)-induced acute colitis.

METHODS

Mice were exposed to DSS and received gelatin tannate by gavage. At sacrifice, colon histological degree of inflammation was assessed. Stool samples were cultured for microbiological analysis. Colon samples were analysed by two-photon confocal microscopy and atomic force microscopy. Elisa was performed on murine serum to assess lipopolysaccharide and peptidoglycan levels.

RESULTS

Gelatin tannate treatment reduced disease activity, bodyweight loss, and preserved colonic length. It produced a decrease in the amount of enterobacteria and enterococci. At confocal microscopy, intestinal samples from healthy and treated mice displayed similar structure in mucus layer thickness and composition; samples from placebo group had no mucus layer or a thinner stratus. Atomic force microscopy confirmed these findings. Treated mice showed lower blood LPS levels vs. control.

CONCLUSIONS

Gelatin tannate decreased the severity of colitis. Acting as a gut barrier enhancer, it re-establishes gut homeostasis by recovering intestinal permeability and mucus layer integrity in gut mucosa and by modulating microbiota composition.