Oral rehydration therapy may prove to be mankind's most significant therapeutic advance this centu ry. Diarrheal d isease remains the number o ne killer of children in the world and is a major cause of illness within Canada and o ther developed countries. Since its discovery 30 years ago, o ral rehydration therapy, comprising glucose, salt and water, has been a simple and low cost treatment for people with life threatening diarrheal disease. Recent developments in solutions for o ra l rehydration therapy have led to the recognition chat the existing World Health Organization glucose based o ral replacement salt could be improved. ln commercially available rehydration solutions, the sodium concentration has been lowered to reduce hypernatremia in noncholera induced diarrhea. Citrate has replaced bicarbonate as the base in oral replacement solutions to pro long shelf life. O rganic substrates to replace glucose and enhance intestinal fluid and electrolyte absorption without osmotic penalty are being examined. However, their acceptance and proper u tilization in developing countries remains to be determined. Can J Gastroe nterol 1989;3( 1):7-14 Key Words: Absorption, Diarrhea , Glucose cotransport, Intestine, Oral rehydration salt, Oral rehydration therapy, Sodium, World Health Organization La therapie de rehydratation par voie orale RESUME: La rchyd raration par voie orale pourrait bien s'averer le progres therapeutique le plus significatif pour l'humanite. Dans le monde, les maladies accompagnees de diarrhees son t toujours la cause premiere de mortalite infantile et un factcur important d'affections au Canada ct dans Jes au tres pays deve loppes. Dcpuis sa decouvcrte il ya 30 ans de cela, la therapie de rehydratation o rale a base de glucose, de sel et d'eau , est demeuree un traitement simple ct peu onereux pour ceux done la vie est menacee par les diarrhces graves. Des progres recents dans le domaine des solutions destinees ace mode de traitement ont permis de reconnaitre que les sels de remplacemenr a base de glucose, administres oralement, pouvaient etre ameliores. Dans la composition des solutions disponibles sur le marche, la concen tration de sodium a ere diminuce pour reduire l'hypernarremie propre aux diarrhees noncholeriques provoquees. La duree de vie des produits a ere prolongee grace a !'utilisation du citrate plutot que du bicarbonate. Sont presentement a l'ecude les substrats organiques destines a rem placer le glucose, a promouvoir !es secretions intestinales et l'absorption des electrolytes sans encouri r d'inconvenien t osmotique. Leur adoption par les pays en voie de developpement et leur uti lisation correcte restent cependant a determiner.
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