Evaluation of oral hypo‐osmolar glucose‐based and rice‐based oral rehydration solutions in the treatment of cholera in children

Dutta, Dipanjan; Mk, Bhattacharya; Sarkar, Dipanwita; Chatterjee, Arpita; Biswas, Arnab; Chatterjee, Krishnarpan; Nair, G. Balakrish; Sk, Bhattacharya

doi:10.1111/j.1651-2227.2000.tb00386.x

Cited by 27 publications

(14 citation statements)

References 6 publications

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“…In other studies, ORS was shown to decrease the duration of diarrhea and rate of purging. Not surprisingly, rice-based hypoosmolar ORS was better than standard ORS or RO-ORS in cholera patients (25). Rice has the advantage of providing glucose, amino acids, and more calories than an equivalent amount of glucose and is hypoosmolar to standard WHO-ORS.…”

Section: Rice-based Orsmentioning

confidence: 93%

Oral Rehydration Therapy: New Explanations for an Old Remedy

Rao

2004

Annu. Rev. Physiol.

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Diarrheal diseases are among the most devastating illnesses globally, but the introduction of oral rehydration therapy has reduced mortality due to diarrhea from >5 million children, under the age of 5, in 1978 to 1.3 million in 2002. Variations of this simple therapy of salts and sugars are prevalent in traditional remedies in cultures world-wide, but only in the past four decades have the scientific bases for these remedies begun to be elucidated. This review aims to provide a broad understanding of the cellular basis of oral rehydration therapy. The features integral to the success of oral rehydration therapy are active glucose transport in the small intestine, commensal bacteria, and short-chain fatty acid transport in the colon. The review examines these processes and their regulation and considers new approaches that might supplement oral rehydration therapy in controlling diarrheal diseases.

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Section: Rice-based Orsmentioning

confidence: 93%

Oral Rehydration Therapy: New Explanations for an Old Remedy

Rao

2004

Annu. Rev. Physiol.

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“…Thus, it is difficult to find only one explanation for the beneficial effect of Rice-ORS: one explanation would be that rice increased the local colonic concentration of SCFA, which in turn stimulated water absorption and reduced stool output (Argenzio and Whipp, 1979;Roediger and Moore, 1981;Binder and Mehta, 1989;Ramakrishna and Roediger, 1990). Alternatively, stool output may have been reduced by another mechanism as suggested in previous studies (Macleod et al, 1995;Mathews et al, 1999;Dutta et al, 2000;Murphy et al, 2004;Gregorio et al, 2009), which in turn may have increased the SCFA concentration in the stools.…”

Section: Faecal Scfas and Microbiota In Children S Monira Et Almentioning

confidence: 94%

“…Initially, glucose was the first carbohydrate to be used (Desjeux et al, 1994). Then, rice (Molla et al, 1982;Gore et al, 1992;Desjeux et al, 1994;Dutta et al, 2000) and more recently amylase-resistant starch (ARS) (Ramakrishna et al, 2000Raghupathy et al, 2006) added to glucose ORS has proven to be more effective than glucose ORS without ARS.…”

Section: Introductionmentioning

confidence: 99%

Short-chain fatty acids and commensal microbiota in the faeces of severely malnourished children with cholera rehydrated with three different carbohydrates

et al. 2010

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Background: Short-chain fatty acids (SCFAs) liberated by fermentation of complex carbohydrates might stimulate water and salt absorption, and provide energy. The aim of the study was to assess the number and proportion of faecal bacteria and the concentration of SCFAs of severely malnourished children with cholera receiving oral rehydration solution (ORS) containing glucose, amylase-resistant starch (ARS) or rice. Methods: Serial faecal samples were collected from 30 malnourished children with cholera until rehydration and partial nutritional recovery. SCFAs were identified and quantitated by high-performance liquid chromatography. In situ hybridization combined with flow cytometry was used to analyse the microbiota in the faeces. Results: Before treatment the concentration of total SCFA in faecal sample of cholera children was found to be 4.7±0.6 mmol/kg and it increased steadily until 95.0 ± 8.7 mmol/kg at day 28. Among different ORS groups, concentration was significantly higher in the Rice-ORS group at day 1 (Po0.011) and at day 2 (Po0.025). During recovery faecal output was significantly reduced and the number of bacteria also increased faster in the Rice-ORS group than in the glucose-ORS group at day 1 and day 2 (Po0.01), and a modest increase in bacterial number was observed in the glucose-ORS plus ARS group (day 1, P ¼ 0.07; day 2, P ¼ 0.09). Conclusion: Clinical recovery was associated with an increase in bacterial and SCFA concentrations with all three carbohydrates in ORS. However, the increases were significantly higher in children receiving Rice-ORS.

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“…Rice-based ORS solutions have demonstrated advantage over glucose-based solutions in tolerance as well as reduction in frequency and duration of stool output in children and adults with cholera [25,26]. The underlying mechanism is attributed to lower osmolarity due to the polymeric structure of rice carbohydrate, nutritional benefits, and an independent yet unidentified antisecretory effect of rice [27].…”

Section: Rice-based Oral Rehydration Saltmentioning

confidence: 97%

The use of oral rehydration solutions in children and adults

Sentongo

2004

Curr Gastroenterol Rep

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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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Evaluation of oral hypo‐osmolar glucose‐based and rice‐based oral rehydration solutions in the treatment of cholera in children

Abstract: Patients who received rice-based hypo-osmolar ORS had subsequently reduced (p < 0.05) stool output, ORS consumption and diarrhoea duration than the patients who received either WHO-ORS or glucose-based hypo-osmolar ORS.

Cited by 27 publications

References 6 publications

Oral Rehydration Therapy: New Explanations for an Old Remedy

Oral Rehydration Therapy: New Explanations for an Old Remedy

Short-chain fatty acids and commensal microbiota in the faeces of severely malnourished children with cholera rehydrated with three different carbohydrates

The use of oral rehydration solutions in children and adults

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