Tips on the use of oral rehydration solutions.
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The objective of the study was to test the tolerance of a rice-based oral rehydration formula when fed to calves. Six healthy Holstein calves, 1 week of age, were fed the formula instead of milk replacer for 3 days. Pre- and posttreatment results of clinical examination and laboratory parameters were compared. Vital signs, attitude, appetite, clinical hydration status, urine specific gravity, and most routine serum biochemistry test results did not vary and remained within the normal range. Five of the 6 calves developed diarrhea when fed the rice-based formula, which was accompanied by a reduction in fecal pH and presence of reducing sugars in the feces. This effect was reversed when calves were returned to the milk replacer diet at the end of the study. Diarrhea was accompanied by increased water consumption, which allowed the calves to maintain normal hydration status. These results suggest that calves are unable to properly digest the rice-derived carbohydrate, and this type of formula is not recommended for oral rehydration of calves.
Gastric emptying of rice powder electrolyte solution and of glucose electrolyte solution was measured by a marker dilution double sampling technique in 14 and in 16 adult patients respectively after intravenous rehydration during an attack of acute cholera. Six patients who received rice powder electrolyte solution and seven who received glucose electrolyte solution re-attended for a repeat study with the same test meal 16 days later, when fully recovered from cholera. No differences in gastric emptying patterns of the two electrolyte solutions were observed, either in the acute or in the recovered patients. Similarly, gastric emptying of both solutions was rapid during acute cholera and comparable to that observed in recovered patients. This study indicates that gastric emptying is not impaired in acute cholera and that the rate of emptying of oral rehydration solutions is adequate to account for their observed clinical efficacy in fast purging patients with acute cholera.
The observation that the intestinal Na(+)-glucose cotransporter remains intact in most diarrheal illnesses led to development of the life-saving, low-cost technology of oral rehydration salt (ORS) solutions. The primary therapeutic role of ORS solutions is in prevention and treatment of dehydration during management of acute gastroenteritis. Successful oral rehydration therapy involves early use of ORS with maintenance or timely resumption of regular feeding. Since the inception of the oral rehydration approach more than three decades ago, the widespread use of ORS solutions has revolutionized the management and outcomes of acute gastroenteritis in children and adults. The efficacy of the World Health Organization ORS solution and of commercial ORS formulations has been enhanced by reducing osmolarity. Newer formulations of ORS are under active investigation, with promise of added benefits, including promotion of intestinal healing. This article reviews fluid and electrolyte transport in the gastrointestinal tract, the pathophysiologic mechanisms of acute diarrhea, and the basis and formulation of current and newer ORS solutions. Guidelines for efficacious use of ORS in the management of acute gastroenteritis and short gut syndrome are also provided.
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The aim of this research was to provide data to select an ideal packing material to preserve the integrity of oral rehydration salts (ORS), a therapeutic formulation that is essential in developing countries. Previous research had verified that water is the factor that most affects ORS stability. For this research, a pharmaceutical industry prepared an ORS batch that was packed in six different types of packing materials. The humidity determination was made after storage of samples during 36 weeks at room temperature, at room temperature with 76% relative humidity, and at 40 degrees C with 80% relative humidity. The moisture in the samples was measured at pre-determined intervals using methods like loss on drying at 50 degrees C and the Karl Fischer method. The results indicated that the most efficient packing material was composed of 18g polyester, 35 g aluminum, and 50 g polyethylene (packing material no. 6).
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An oral electrolyte solution made with rice syrup solids was found to reduce fecal output more effectively than a comparable glucose-based solution in the early hours of treatment of infantile diarrhea. Administration of the rice syrup solids solution was also more effective in promoting absorption of fluid, sodium, and potassium. In some infants, the rapid, effective rehydration offered by this solution may prevent the need for hospitalization.
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OBJECTIVE: In a randomized, double-blind, controlled clinical trial we compared the efficacy of adding 90 mmol/L L-glutamine to the standard World Health Organization oral rehydration salts (WHO-ORS). SUBJECTS: One hundred twenty male infants, > 1 month and < 1 year of age, with acute non-cholera diarrhea and dehydration were randomly assigned to one of the two treatment groups. METHODS: Patients were kept in a metabolic unit where body weight, ORS, water and food intake, as well as stool, urine and vomitus output were recorded at 6-hour intervals. Laboratory evaluation, including blood gases and electrolytes, were monitored during hospitalization. RESULTS: Diarrheal stool output, duration of diarrhea and volume of ORS required to achieve and maintain hydration was not significantly different between the treatment groups. CONCLUSION: This study demonstrated that a glutamine-based ORS did not provide any additional therapeutic advantage over the standard WHO-ORS during treatment of dehydration in infants with acute non-cholera diarrhea.
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