Review · Journal of pediatric gastroenterology and nutrition · 2018Abstract only

Starch tolerance and short bowel syndrome nutrition

What it found

In short bowel syndrome, starch is likely the most important complex carbohydrate because it is almost completely absorbed or fermented.

The authors say supplementing it may help the gut adapt, but risks like bacterial overgrowth and D-lactate acidosis need careful weighing.

What they found

Starch absorption

Starch is probably the most important complex carbohydrate in short bowel syndrome nutrition because it is absorbed or fermented almost completely.

Benefits of complex carbs

Supplementing with complex carbohydrates may improve adaptive processes, have positive trophic effects on the gut lining and its hormonal response, lengthen transit time, and possibly speed up weaning from parenteral nutrition.

Risks to weigh

Supplementation advice needs to carefully weigh risks and benefits, especially bacterial overgrowth, osmotic load, and D-lactate acidosis.

Colon preservation

Keeping at least portions of the colon in continuity with the small bowel is an important prognostic factor.

Carbohydrate digestion

The changed physiology of carbohydrate digestion plays a major role in the adaptation process and can be a target for specific enteral nutrition interventions.

What the authors conclude

“Starch is probably the most important complex carbohydrate in short bowel syndrome nutrition, because it is absorbed or fermented almost completely.”
de Laffolie J, Naim HY, Rudloff S, Zimmer KP, 2018

Also in their conclusions

  • They say starch is probably the most important complex carbohydrate in short bowel syndrome nutrition because it is absorbed or fermented almost completely.
  • They advise that supplementation advice needs to weigh carefully the risks and benefits, especially considering bacterial overgrowth, osmotic load, and D-lactate acidosis.

How it was done

Short bowel syndrome with intestinal failure is a rare disease that greatly lowers quality of life and needs a team approach to medical, surgical and nutritional care. Current drug and surgery options are limited, so nutrition is a key cornerstone.

What it can’t tell you

  • We summarised it from the abstract only.
  • This is a review, not a new study in people or animals, so it cannot show cause and effect.
  • It does not provide numbers on how much starch helps or harms people with short bowel syndrome.

The paper

Title
Starch Tolerance and the Short Bowel
Type
ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
Summarised from
Abstract only
Cite
de Laffolie J, Naim HY, Rudloff S, Zimmer KP (2018). Starch Tolerance and the Short Bowel. Journal of pediatric gastroenterology and nutrition. doi:10.1097/MPG.0000000000001962PubMed 29762383DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error