Oral rehydration formula containing alanine and glucose for treatment of diarrhoea: a controlled trial (original) (raw)
Related papers
Oral Rehydration Solutions in Non-Cholera Diarrhea: A Review
The American Journal of Gastroenterology, 2009
The use of oral rehydration solution (ORS) has revolutionized the management of acute diarrhea. The implementation of the standard World Health Organization ORS (WHO-ORS) has resulted in decreased mortality associated with acute diarrheal illnesses in children, although in general stool volume and diarrhea durations are not reduced. Decreased morbidity and mortality have occurred because of improved hydration status. Decreased morbidity has also been described in adults who used this therapy. Various modifi cations to the standard ORS have been derived. These modifi cations have included hypo-osmolar or hyperosmolar solutions, use of rice-based ORS, zinc supplementation, and the use of amino acids, including glycine, alanine, and glutamine. Some of these variations have been successful, some have not, and others are still under investigation. ORS has been used for travelers ' diarrhea and to decrease intravenous (IV) fl uid requirements in patients with short bowel syndrome (SBS) who require parenteral nutrition (PN). This paper reviews the standard WHO-ORS and its mechanism of action, followed by more contemporary reduced osmolarity ORS and rice-based ORS in non-cholera diarrhea. Various modifi cations to improve ORS are also discussed.
Evaluation of two intravenous rehydration solutions in cholera and non-cholera diarrhoea
Bulletin of the World Health Organisation
A clinical trial was carried out with 126 male patients over 2 years ofage suffering from diarrhoea requiring intravenous rehydration, 80 of the patients sufferingfrom cholera and 46 from non-cholera diarrhoea. A new "diarrhoea treatment solution " (DTS) containing sodium at a concentration of 118 mmol/litre and glucose at 44 mmol/litre was compared with the usual Dacca intravenous solution (DS) which has a sodium concentration of 133 mmol/litre and contains no glucose. The other constituents and their concentrations were the same in both solutions. All the patients responded well clinically and made an uneventful recovery. Oral water intake measured during the first 24 h was higher in the group receiving the DS. This group also excreted a significantly higher quantity ofsodium in the urine. A significant fall in the level of blood glucose from the admission values occurred in both the groups; the fall was relatively less in the DTS group, this solution containing 44 mmol of glucose per litre. Further work is required to find the optimum concentration of glucose in the solution for infants and young children.
Journal of health, …, 2007
This study assessed whether an oral rehydration solution (ORS) in which glucose is replaced by Lglutamine (L-glutamine ORS) is more effective than the standard glucose-based rehydration solution recommended by the World Health Organization (WHO-ORS) in reducing the stool volume and time to rehydrate in acute diarrhoea. In a double-blind, randomized controlled trial in a Mexican hospital, 147 dehydrated children, aged 1-60 month(s), were assigned either to the WHO-ORS (74 children), or to the L-glutamine ORS (73 children) and followed until successful rehydration. There were no significant differences between the groups in stool output during the first four hours, time to successful rehydration, volume of ORS required for rehydration, urinary output, and vomiting. This was independent of rotavirus-associated infection. An L-glutamine-containing glucose-free ORS seems not to offer greater clinical benefit than the standard WHO-ORS in mildly-to-moderately-dehydrated children with acute non-cholera diarrhoea.
Journal of Health, Population, and Nutrition, 2007
This study assessed whether an oral rehydration solution (ORS) in which glucose is replaced by L-glutamine (L-glutamine ORS) is more effective than the standard glucose-based rehydration solution recommended by the World Health Organization (WHO-ORS) in reducing the stool volume and time to rehydrate in acute diarrhoea. In a double-blind, randomized controlled trial in a Mexican hospital, 147 dehydrated children, aged 1–60 month(s), were assigned either to the WHO-ORS (74 children), or to the L-glutamine ORS (73 children) and followed until successful rehydration. There were no significant differences between the groups in stool output during the first four hours, time to successful rehydration, volume of ORS required for rehydration, urinary output, and vomiting. This was independent of rotavirus-associated infection. An L-glutamine-containing glucose-free ORS seems not to offer greater clinical benefit than the standard WHO-ORS in mildly-to-moderately-dehydrated children with acut...
Rice-based oral rehydration solution decreases the stool volume in acute diarrhoea
Bulletin of the World Health Organization, 1985
A randomized trial using oral rehydration solutions (ORS) with rice or glucose was carried out in 342 patients with acute watery diarrhoea. On admission, 75% of these patients had severe dehydration and 70% werepositivefor Vibrio cholerae. There were 185 children aged under 10 years and 157 adults; 169 patients were treated with rice-ORS and 173 with glucose-ORS. Patients in both groups were comparable in age and body weight, as well as the duration and severity of illness. Patients with severe dehydration were first rehydrated intravenously, and then treated with ORS. Those with moderate dehydration received ORSfrom the beginning. The mean stool output in the first 24 hours in children treated with rice-ORS was less than that in those treated with glucose-ORS (155 vs 204 ml/kg/24 h; P < 0.01). The same was truefor the adult patients, the corresponding values for stool output being 115 vs 159 ml/kg/24h (P < 0.05). The mean ORS intake in children was263.5 vs379.6 ml/kg/24 h, respectively, for rice-ORS and glucose-ORS (P <0.05); the corresponding intakes in adult patients were, respectively, 180.5 and 247 ml/kg/24 h. A gain ofabout 10% ofthe body weight on admission was observed in all the groups. Six cases (4 children and 2 adults), who failed to respond to oral rehydration after intravenous therapy, all belonged to the glucose-ORS group.