The Use of Oral Rehydration Solutions in Children and Adults

Overview

Journal Curr Gastroenterol Rep

Specialty Gastroenterology

Date 2004 Jul 13

PMID 15245700

Citations 9

Authors

Timothy A Sentongo

Affiliations

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Abstract

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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References

Aranda-Michel J, Giannella R . Acute diarrhea: a practical review. Am J Med. 1999; 106(6):670-6. PMC: 7124219. DOI: 10.1016/s0002-9343(99)00128-x. View

Dutta D, Bhattacharya M, Deb A, Sarkar D, Chatterjee A, Biswas A . Evaluation of oral hypo-osmolar glucose-based and rice-based oral rehydration solutions in the treatment of cholera in children. Acta Paediatr. 2000; 89(7):787-90. View

Hirschhorn N, Greenough 3rd W . Progress in oral rehydration therapy. Sci Am. 1991; 264(5):50-6. DOI: 10.1038/scientificamerican0591-50. View

Alam N, Majumder R, FUCHS G . Efficacy and safety of oral rehydration solution with reduced osmolarity in adults with cholera: a randomised double-blind clinical trial. CHOICE study group. Lancet. 1999; 354(9175):296-9. DOI: 10.1016/s0140-6736(98)09332-5. View

Ziegler T, Szeszycki E, Estivariz C, Puckett A, Leader L . Glutamine: from basic science to clinical applications. Nutrition. 1996; 12(11-12 Suppl):S68-70. DOI: 10.1016/s0899-9007(96)00019-6. View

Gore S, Fontaine O, Pierce N . Efficacy of rice-based oral rehydration. Lancet. 1996; 348(9021):193-4. DOI: 10.1016/s0140-6736(05)66136-3. View

Christensen M . Human viral gastroenteritis. Clin Microbiol Rev. 1989; 2(1):51-89. PMC: 358100. DOI: 10.1128/CMR.2.1.51. View

King C, Glass R, Bresee J, Duggan C . Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep. 2003; 52(RR-16):1-16. View

Carabin H, Gyorkos T, Soto J, Joseph L, Payment P, Collet J . Effectiveness of a training program in reducing infections in toddlers attending day care centers. Epidemiology. 1999; 10(3):219-27. View

10.

Go J, Harper R, Sia C, Teichberg S, Wapnir R . Oral rehydration solutions: increased water and sodium absorption by addition of a viscosity-enhancing agent in a rat model of chronic osmotic diarrhea. J Pediatr Gastroenterol Nutr. 1994; 19(4):410-6. View

11.

Royall D, Wolever T, Jeejeebhoy K . Clinical significance of colonic fermentation. Am J Gastroenterol. 1990; 85(10):1307-12. View

12.

. Multicenter, randomized, double-blind clinical trial to evaluate the efficacy and safety of a reduced osmolarity oral rehydration salts solution in children with acute watery diarrhea. Pediatrics. 2001; 107(4):613-8. DOI: 10.1542/peds.107.4.613. View

13.

Ramakrishna B, Venkataraman S, Srinivasan P, Dash P, Young G, Binder H . Amylase-resistant starch plus oral rehydration solution for cholera. N Engl J Med. 2000; 342(5):308-13. DOI: 10.1056/NEJM200002033420502. View

14.

Hirschhorn N . The treatment of acute diarrhea in children. An historical and physiological perspective. Am J Clin Nutr. 1980; 33(3):637-63. DOI: 10.1093/ajcn/33.3.637. View

15.

Modigliani R, BERNIER J . Absorption of glucose, sodium, and water by the human jejunum studied by intestinal perfusion with a proximal occluding balloon and at variable flow rates. Gut. 1971; 12(3):184-93. PMC: 1411596. DOI: 10.1136/gut.12.3.184. View

16.

Parimi P, Devapatla S, Gruca L, Amini S, Hanson R, Kalhan S . Effect of enteral glutamine or glycine on whole-body nitrogen kinetics in very-low-birth-weight infants. Am J Clin Nutr. 2004; 79(3):402-9. DOI: 10.1093/ajcn/79.3.402. View

17.

Altaf W, Perveen S, Rehman K, Teichberg S, Vancurova I, Harper R . Zinc supplementation in oral rehydration solutions: experimental assessment and mechanisms of action. J Am Coll Nutr. 2002; 21(1):26-32. DOI: 10.1080/07315724.2002.10719190. View

18.

Nappert G, Barrios J, Zello G, Naylor J . Oral rehydration solution therapy in the management of children with rotavirus diarrhea. Nutr Rev. 2000; 58(3 Pt 1):80-7. DOI: 10.1111/j.1753-4887.2000.tb01844.x. View

19.

Hoffmann J, Zeitz M . Small bowel disease in the elderly: diarrhoea and malabsorption. Best Pract Res Clin Gastroenterol. 2002; 16(1):17-36. DOI: 10.1053/bega.2002.0263. View

20.

Mirza N, Caulfield L, Black R, Macharia W . Risk factors for diarrheal duration. Am J Epidemiol. 1997; 146(9):776-85. DOI: 10.1093/oxfordjournals.aje.a009354. View