|Year : 1995 | Volume
| Issue : 1 | Page : 5-8
Comparative evaluation of gastric secretory response to banana and porridge
RC Dadoo, HL Khatri, Sham Singla
Medical College and Hospital, Rohtak, Haryana, India
|Date of Submission||02-Mar-1994|
R C Dadoo
Medical College and Hospital, Rohtak, Haryana
|How to cite this article:|
Dadoo R C, Khatri H L, Singla S. Comparative evaluation of gastric secretory response to banana and porridge. Indian J Med Sci 1995;49:5-8
The term bland food is used to describe various constituents of food which stimulate minimum acid secretion in the stomach. Banana is one of the constituents of bland diet prescribed for peptic ulcer patients. It has been suggested that banana might neutralise or buffer gastric acid.  Alternatively, banana's soft consistency might have a protective action against mechanical irritation.  Flour made out of dried green plantain is used as bread (chapatis) in cases of dyspepsia with flatulence and acidity.  Gruel made up of banana flour and milk has been often prescribed in cases of gastritits. The available literature suggests that unripe banana has antiulcerogenic properties  but no study could be found on similar effect of ripe banana. However, patients commonly take ripe banana rather than unripe presuming it to be a bland food. The senior author, who himself suffers from nonulcer dyspepsia, observed aggravation of his symptoms after taking ripe banana. This and a few such other observations on a limited number of patients encouraged us to study the effect of ripe banana on gastric secretion.
| ¤ Material and Methods|| |
The study was carried out in 115 patients admitted in a surgical ward of Medical College and Hospital, Rohtak. The patients were divided into three groups : 1. Group A : Comprised of 89 patients without GIT symptoms 2. Group B: Comprised of 11 patients having sysptoms of acid peptic disease without ulcer (ruled out on barium meal study and endoscopy). 3. Group C: Consisted of 15 proved peptic ulcer patients.
Patients were advised to keep fasting after 9.00 p.m. Onwards. Smoking, drugs and any exercise were prohibited. After 12 hr. overnight fast a nasogastric tube was passed to aspirate the fasting gastric contents. Then patients were fed ripe banana (80 gms) and porridge (80 gm) on two separate days. This was followed by collection of gastric juice after every 15 minutes till 2 hrs. The free and total acid in each sample were measured by titrating against 0.1 N NaOH to pH 7.0 by using Toeffer's reagent in miii equivalents per litre.
| ¤ Results|| |
Majority of the patients included in this study were males (M: 83, F:32).
Fasting or Basal Total Acid In Group A the range of total acid varied from 0-56 mEq/I with an average of 27.48 mEq/L. In group B the range of fasting gastric juice acid content was 60,68 mEq/L with an average of 62.5 mEq/L while figures for Group C were 82-170 and 112.59 mEq/L respectively. Total acid output after porridge and banana meal In Group A mean acid production was 47.93 mEq/L with a range of 25-80 mEq/LL following porridge meal compared with mean acid production of 111.26 mEq/L and range of 44-148 mEq/L following ripe banana meal. Similarly, in Group B mean value after porridge meal was 85.33 mEq/L (range 70-93 mEq/L) compared with 126.83 mEq/L (range 122-137 mEq/L) of acid with ripe banana meal. In Group C the mean value following porridge meal was 139.17 mEq/L mEq/L (range 9-200 mEq/L) in contrast to 191.25 mEq/L (range 132-240 mEq/L) with ripe banana meal.
Free acid output after porridge and banana meal: In group A the mean free acid value was 37.45 mEq/L with a range of 20-70 mEq/L following porridge meal as compared to mean value of 98.03 mEq/L (range 36-135 mEq/L) following banana meal. Similarly in group B the free acid values were higher following banana meal (117.29 mEq/L) compared with porridge meal (75.54 mEq/L). In group C the mean free acid values were also higher following a banana meal (130.26 mEq/L) compared with porridge meal (89.95 mEq/L). Thus, it has been seen that total and free acid production following a porridge meal was always lower than that following ripe banana meal and these values were statistically significant (By 't' test p <0.001) .
| ¤ Discussion|| |
The usual ripe banana available in this part of country has been chosen for the study as that would be the one which would be taken by the patients when prescribed as bland diet. We have intentionally avoided consideration of different biological variables of a different varieties of banana because when it is prescribed the patient may not differentiate between them. We have observed in our study that the values of total acidity were statistically higher (p<0.001) in response to banana test meal in all the three groups as compared to porridge test meal. It is not possible to compare the results of present study with any other series as such study with ripe banana and porridge is -not available in the literature to the best of our knowledge. Unripe banana of "Musa paradesiaca sepientum" variety has antiulcerogenic effect but ripe banana failed to show any antiulcerogenic property rather it led to more acid production compared with porridge, made of wheat, relatively a bland food. Unripe banana has been found to contain 37%, starch granules which cannot be digested by amylase compared with 3% content of such starch granules in ripe banana.  Could it be that higher content of undigestible starch in unripe banana makes it a blend food compared with ripe one. This study has proved ripe banana increased free and total acidity in normal subjects, patients with nonulcer dyspepsia and in peptic ulcer patients. To conclude, ripe banana should not be prescribed as bland diet while treating patients of acid peptic disease.
| ¤ Summary|| |
Unripe Banana (Plantain) is used in South India as a bland diet for peptic ulcer patients. Flour made of plantain is quite often prescribed in dyspepsia in this part of the country. This has led to the belief that ripe banana may also be a bland fruit. However, it was observed by the Senior Author that ripe banana does produce symptoms of hyperacidity. Hence a study was undertaken to assess whether ripe banana is a bland food or not. A total of 115 patients entered the study. 89 individuals had no GIT symptoms, 15 patients had proved peptic ulcer while 11 patients had non-ulcer acid dyspepsia. The gastric residue was emptied by a nasogastric tube after a night fast. Patients were then given 80 gms. of banana or porridge on two different days. Then consecutive 15 minute samples of gastric juice were collected and submitted for estimation of acid output in mEq/I. It was observed that gastric acid values were higher following banana as compared to porridge and the difference was statistically significant (p <0.001). It was thus concluded that ripe banana is not a bland food. It should not be recommended as a part of bland diet for patients of acid peptic disease.
| ¤ References|| |
|1.||Hanszen A. The bactericidal power of the stomach and some factors which influence it. Am J Digest Dis Nutr 1934;1:725-7. |
|2.||Elliott RC, Heward GJF. The influence of a banana supplemented diet on gastric ulcers in mice. Pharmacol Res Commun 1976;8:167-71. |
|3.||Nandkarni KM. Musa sapientum, Kuntzee or M. Paradisiaca. In : Nandkarni AK eds. Indian Materia Medica with Ayurvedic, Unani and Home remedies. Bombay : Popular Book Depot. 194:822-57. |
|4.||Goel RK, Chakrabarti A, Sanyal AK. The effect of biological variables on the antiulcerogenic effect of vegetable plantain banana. Planta Medica 1985;2: 85-8. |
|5.||Englyst HN, Cummings JH. Digestion of the carbohydrates of banana (Musa paradisiaca sapientum) in the human small intestine. Am J Clin Nuti 1986;44:42-50. |
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