The colonic epithelial cells utilize SCFAs as source of energy for their various metabolic activities (27, 28). Human colonocytes use butyrate in preference to glucose, glutamine or ketone bodies as fuel source (27). Thus, in contrast to small intestinal cells, colonic epithelial cells derive the major part of their energy supply from the lumen rather than from the blood. Depriving luminal nutrition of the mucosa has been found to induce fluid secretion (29). The lack of luminal SCFAs in the colon may be involved in special diarrhoeal states such as diversion colitis and antibiotic associated diarrhoea. Diarrhoea is not uncommon after abdominal operations, particularly after closure of a temporary colostomy (30). Although there is no proof, this postoperative diarrhoea might be attributed to lack SCFAs in the colon, which might perhaps be reversed by the intake of fermentable fiber (31). Lengthy preoperative bowel preparation by antibiotic and lavage, and diminished oral nutrition probably contributes to postoperative diarrhoea. Lack of luminal SCFAs can similarly explain the diarrhoea often seen in the terminal stages of malnutrition and starvation. In these conditions, intestinal infections might not always be implicated and it seems likely that diarrhoea is a manifestation of organ-specific malnutrition of the colon (32). Diarrhoea is often associated with the use of broad-spectrum antibiotics, and colonization by toxin producing clostridium difficile accounts for only a third of these cases (33). The use of antibiotics suppresses the formation of SCFAs from fermentable carbohydrate (34), a feature that might also be responsible for diarrhoea. Although there are lots of data suggesting antidiarrhoeal effect of fermentable fibers, their therapeutic application in diarrhoeal disease is yet to be examined. Some recent clinical studies have demonstrated the beneficial effect of dietary fiber in treatment of adult cholera (35) and in the treatment of children with acute diarrhoea (36). In children with acute diarrhoea, Benefiber-added ORS has been observed to reduce the mean duration of diarrhoea by 16 hours, (74 vs. 90 h; p <0.05). Further studies are required to evaluate the effect of Benefiber in reducing severity and duration of cholera, a form of severe dehydrating diarrhoea.