Treatment of acute diarrhea with oral rehydration solutions containing glutamine.

Júnior, H Ribeiro; Ribeiro, Thaís Regina Silva; Mattos, Ângela Peixoto de; Palmeira, Cátia Suely; Fernández, Doroteo Acero; Santana, Isabelle; Rodrigues, Isabelle; Bendicho, Maria Teresita; Fontaine, Olivier

doi:10.1080/07315724.1994.10718405

Cited by 39 publications

(16 citation statements)

References 22 publications

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“…Three double-blind randomized controlled trials have tested the efficacy of oral Gln in the treatment of diarrheal disease in infants and children [160–162] (Table 4). Ribeiro Jr. et al [160] studied 118 infants (1–12 months of age) with acute noncholera diarrhea and dehydration and reported that Gln-based ORS did not provide additional benefit over the standard World Health Organization (WHO)-ORS with respect to diarrheal stool output, duration of diarrhea, or volume of ORS needed to achieve/maintain hydration.…”

Section: Resultsmentioning

confidence: 99%

“…Ribeiro Jr. et al [160] studied 118 infants (1–12 months of age) with acute noncholera diarrhea and dehydration and reported that Gln-based ORS did not provide additional benefit over the standard World Health Organization (WHO)-ORS with respect to diarrheal stool output, duration of diarrhea, or volume of ORS needed to achieve/maintain hydration. This initial trial was generally of good methodological quality; however, the addition of Gln to the standard WHO-ORS led to a higher osmolality versus standard, and osmolality could affect diarrheal symptoms.…”

Section: Resultsmentioning

confidence: 99%

“…Although solutions were of similar osmolality, glucose-free Gln-based ORS did not appear to reduce stool output, volume of ORS or time required for rehydration, urine output, or vomiting. The indeterminate results of both trials could be explained by subjects being only mildly to moderately dehydrated, since ORS is more effective when given to dehydrated patients [160, 161]. Furthermore, the early feeding just after rehydration may have blunted the effects of Gln [160].…”

Section: Resultsmentioning

confidence: 99%

“…The indeterminate results of both trials could be explained by subjects being only mildly to moderately dehydrated, since ORS is more effective when given to dehydrated patients [160, 161]. Furthermore, the early feeding just after rehydration may have blunted the effects of Gln [160]. Finally, Gln may have a lesser effect on intestinal absorption of water and sodium in noncholera diarrhea compared to when the secretory component of the diarrheal episode is more severe (i.e., when there is a relatively larger secretion of sodium and chloride) [155, 156].…”

Section: Resultsmentioning

confidence: 99%

“…Although apparently safe and well tolerated, results from double-blind randomized controlled trials are conflicting regarding the efficacy of oral Gln in the treatment of diarrheal disease [160–162, 168] or in enhancing intestinal barrier function [167–169] or growth [167–169] in children suffering from diarrhea or malnutrition. Furthermore, any beneficial effect of oral Gln does not seem to result from a modulation of the immune response [161, 167].…”

Section: Resultsmentioning

confidence: 99%

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Glutamine Supplementation in Sick Children: Is It Beneficial?

Mok

Hankard

2011

Journal of Nutrition and Metabolism

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The purpose of this review is to provide a critical appraisal of the literature on Glutamine (Gln) supplementation in various conditions or illnesses that affect children, from neonates to adolescents. First, a general overview of the proposed mechanisms for the beneficial effects of Gln is provided, and subsequently clinical studies are discussed. Despite safety, studies are conflicting, partly due to different effects of enteral and parenteral Gln supplementation. Further insufficient evidence is available on the benefits of Gln supplementation in pediatric patients. This includes premature infants, infants with gastrointestinal disease, children with Crohn's disease, short bowel syndrome, malnutrition/diarrhea, cancer, severe burns/trauma, Duchenne muscular dystrophy, sickle cell anemia, cystic fibrosis, and type 1 diabetes. Moreover, methodological issues have been noted in some studies. Further mechanistic data is needed along with large randomized controlled trials in select populations of sick children, who may eventually benefit from supplemental Gln.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Glutamine Supplementation in Sick Children: Is It Beneficial?

Mok

Hankard

2011

Journal of Nutrition and Metabolism

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Scientific Rationale for a Change in the Composition of Oral Rehydration Solution

Duggan

Fontaine

Pierce

et al. 2004

JAMA

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Efficacy of a Glutamine‐Based Oral Rehydration Solution on the Electrolyte and Water Absorption in a Rabbit Model of Secretory Diarrhea Induced by Cholera Toxin

Silva,

Santos‐Neto,

Soares

et al. 1998

J. pediatr. gastroenterol. nutr.

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Background:Glutamine is absorbed in the intestinal tract coupled with sodium and is the principla metabolic substrate for the enterocyte. Therefore, an oral rehydration solution containing this substance might provide an effective oral means of restoring electrolyte losses as well as speeding repair of mucosal damage. The objective of this work was to investigate the use of an oral rehydration solution based on glutamine in vivo in the perfused rabbit ileal loop model of secretory diarrhea induced by choleratoxin.Methods:Phenolsulfonphthalein (PSP, 50 mg/l) was used as a nonabsorbable marker for calculations of net water and electrolyte transport. Solutions tested included: (a) a glutaminebased oral rehydration solution with 111 mmol/l glutamine, (Gln‐ORS); (b) the oral rehydration solution recommended by the World Health Organization; (c) modified Ringer's solution. Choleratoxin (1μg/ml) was injected into the lumen of the ileal rabbit segments for 30 minutes prior to the initiation of the perfusion.Results:Choleratoxin induced significant secretion of sodium in the control modified Ringer's solution (10.8 ± 2.95 vs ‐14.05 ± 5.95μEq/g/min, n = 10; p < 0.01) and of water (0.06± 0.03 vs ‐0.15 ± 0.06 ml/g/min, n = 10; p< 0.01) with a maximum effect at 60 minutes after initiation of perfusion. World Health Organization oral rehydration solution was able to significantly reduce the intestinal secretion of sodium (control with cholera = ‐14.34± 2.18 vs oral rehydration solution with cholera = ‐0.50 ± 0.48μEq/g/min, n = 10; p < 0.01) and water (‐0.15± 0.02 vs ‐0.012 ± 0.005 ml/g/min, n = 10; p< 0.01). For comparison, glutamine‐based oral rehydration solution had an even greater effect on sodium and water absorption (glutamine‐based oral rehydration solution with choleratoxin = 10.31 ± 1.21 μEq/g/min,n = 5; p < 0.01 for sodium and 0.08 ± 0.008 ml water/g/min; n = 5; p < 0.01). Choleratoxin did not change the effect of glutamine‐based oral rehydration solution on sodium and water absorption (12.90 ± ‐1.09 μEq sodium/g/min, n = 5; and 0.11 ± 0.01 ml water/g/min; n = 5). In addition glutamine‐based oral rehydration solution also induced a greater absorption of potassium and chloride in the intestinal ileal segments treated with cholera toxin compared with World Health Organization glutamin‐based oral rehydration solution.Conclusions:These results demonstrate the superior efficacy of glutamine‐based oral rehydration solution in electrolyte and water absorption compared with modified Ringer's control solution or even with World Health Organization‐recommended oral rehydration solution.

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Treatment of acute diarrhea with oral rehydration solutions containing glutamine.

Abstract: 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.

Cited by 39 publications

References 22 publications

Glutamine Supplementation in Sick Children: Is It Beneficial?

Glutamine Supplementation in Sick Children: Is It Beneficial?

Scientific Rationale for a Change in the Composition of Oral Rehydration Solution

Efficacy of a Glutamine‐Based Oral Rehydration Solution on the Electrolyte and Water Absorption in a Rabbit Model of Secretory Diarrhea Induced by Cholera Toxin

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