In developing countries, dehydration from acute diarrhea results in the death of over 4 million children under 5 years of age each year. Over 90% of these cases could be treated by oral rehydration.
The World Health Organization (WHO) recommends an oral rehydration solution containing sodium 90 mmol/L and glucose 111 mmol/L. This is an effective treatment for diarrhea in both adults and children.
However, recent studies suggest that new reduced osmolarity solutions may reduce vomiting, stool output, and the need for intravenous rehydration in patients with acute diarrhea.
Dr Seokyung Hahn and colleagues conducted a systematic review of 15 trials of reduced oral rehydration solution, including 2,397 randomized patients.
The review found that reduced osmolarity rehydration solution results in fewer unscheduled intravenous infusions, compared with the WHO rehydration solution (odds ratio of 0.61)
|Diarrheal dehydration can be treated by oral rehydration in over 90% of patients.
|British Medical Journal|
Vomiting (odds ratio 0.71) and stool output were also reduced.
Although the new therapy shows improved efficacy, barriers to its success in the developing world remain.
Dr George Fuchs, writing an editorial in the same journal, suggests that, in the developing world, there is widespread skepticism about the efficacy of oral rehydration solution.
Standard WHO rehydration solution does little to reduce diarrheal stool output. According to Dr Fuchs, this may be the criterion by which the efficacy of a treatment for acute diarrhea is judged by communities in the developing world.
Reduced osmolarity rehydration solution causes some decrease in stool output. However, Dr Fuchs believes it may not be sufficient to overcome misperceptions of the treatment in many parts of the world.