Efficacy of nutritive hyperosmolar glucose-based oral rehydration solutions in a model of chronic diarrhea

ABSTRACT

The essential constituents of a conventional oral rehydration solution [ORS] are sodium, glucose and a bicarbonate precursor. The glucose promotes sodium uptake but because these solutions are isotonic, it is insufficient to sustain calorie requirements. This paper examines the efficacy of a novel ORSs with twice and three times the conventional glucose concentration, by comparing it with the WHO-ORS in an experimental model of chromic diarrhea in rats. Rats were either treated or not for one weak with magnesium citrate- phenolphthalein to produce chronic osmotic- secretory diarrhea. Intestinal absorption of fluids and solutes were measured using in vivo intestinal perfusion method. Plasma changes were evaluated 4 hours after the beginning of intestinal perfusion. Inclusion of additional glucose enhances fluids and solutes absorption, though, absorption of the ORS containing twice the conventional glucose concentration of WHO-ORS was superior to ORS with three times the conventional glucose concentration. Novel hgpertonic solutions showed also greater ability to correct hypoglycemia, hyponatremia metabolic acidosis in diarrheal rats. It, therefore, appears possible to depart from the traditional isotonic formulations in cases of long standing diarrhea and gain significant nutritional support while retaining effective intestinal absorption and correction of acidbase and electrolyte disturbances. This seems especially important in infants where energy deprivation imposes a particular penalty. The use of a novel ORSs should not, however, be extended to other species without further research