Starch digestion and nutrition in people with short bowel syndrome
What it found
In people with short bowel syndrome, starch is almost fully absorbed or fermented by gut bacteria.
Adding complex carbohydrates may help the gut adapt but carries some risks.
What they found
Studies in people
Starch absorption and fermentation
Starch is likely the most important complex carbohydrate for people with short bowel syndrome. It is absorbed or fermented by gut bacteria almost completely.
Benefits of complex carbohydrates
Adding complex carbohydrates can improve gut adaptation and support the gut lining and its hormone responses. It also slows down how fast food moves through the gut.
Weaning from vein feeding
Supplementing with complex carbohydrates might help people stop needing vein feeding sooner.
Risks to weigh up
Doctors must balance benefits against risks like bacterial overgrowth, extra fluid drawn into the gut, and a type of acid buildup called D-lactate acidosis.
Keeping the colon matters
Having at least part of the colon still connected to the small bowel is an important sign of a better outcome.
What the authors conclude
- They state that starch is likely the most important complex carbohydrate for nutrition in short bowel syndrome because it is nearly fully absorbed or fermented.
- They advise that adding complex carbohydrates can help the gut adapt but requires careful weighing of benefits against risks like bacterial overgrowth and acid buildup.
How it was done
Short bowel syndrome is a rare condition that severely affects quality of life and needs medical, surgical, and nutritional care. Current drug and surgery options are limited, so feeding through the gut or veins is a key part of treatment.
The authors reviewed how carbohydrate digestion changes in people with short bowel syndrome. They looked at gut anatomy, how well the small bowel absorbs nutrients, adaptation processes, and gut bacteria. No specific number of patients or study duration was given.
What it can’t tell you
- We summarised it from the abstract only.
- This is a review, so it cannot prove that starch directly causes better outcomes on its own.
- Individual results may vary depending on how much small bowel and colon a person has left.
Who paid
- Authors work at
- Justus Liebig University Giessen, Giessen; University of Veterinary Medicine, Germany
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.
- Evidence
- Studies in people
- 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 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error