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Evaluation of a sucrose/electrolyte solution for oral rehydration in acute infantile diarrhoea
A Chatterjee1, D Mahalanabis1, K N Jalan1
1Kothari Centre of Gastroenterology, Calcutta Medical Research Institute, and Medical College Hospitals, Calcutta, India.
Insights
Oral sucrose/electrolyte solutions effectively hydrated 19 of 20 children with acute diarrhea dehydration. This safe and affordable treatment option proved successful despite vomiting or abdominal issues.
Area of Science:
- Pediatrics
- Gastroenterology
- Clinical Nutrition
Background:
- Acute diarrhea is a leading cause of dehydration in children.
- Oral rehydration therapy (ORT) is the standard treatment, typically using glucose-based solutions.
- The efficacy of sucrose as a carbohydrate source in ORT requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of an oral sucrose/electrolyte solution for rehydrating children with moderate to severe dehydration due to acute diarrhea.
- To assess the impact of sucrose-based ORT on clinical recovery, biochemical parameters, and intestinal disaccharidase activity.
Main Methods:
- A prospective study involving 20 children (median age 1 year) with moderate to severe dehydration.
- Administration of an oral sucrose/electrolyte solution.
- Assessment of hydration status, clinical recovery, weight changes, and plasma parameters.
- Jejunal mucosal biopsy to measure disaccharidase levels (lactase, sucrase, maltase).
- Sucrose and glucose tolerance tests were performed.
Main Results:
- Complete hydration was achieved in 19 out of 20 children.
- Successful rehydration was indicated by weight gain, normalized plasma bicarbonate, decreased hematocrit, and improved plasma specific gravity.
- Vomiting, abdominal distension, and stool sugar did not impede treatment success.
- Reduced lactase (75%) and sucrase (18%) were observed in jejunal biopsies; maltase levels were adequate.
- All but one child showed normal blood sugar response in tolerance tests.
Conclusions:
- Oral sucrose/electrolyte solutions are highly effective for rehydrating children with moderate to severe dehydration from acute diarrhea.
- Sucrose is a viable and cost-effective alternative to glucose in ORT.
- This approach offers a significant advantage due to sucrose's low cost and availability.
Abstract:
An oral sucrose/electrolyte solution brought about complete hydration in 19 out of 20 consecutive children with a median age of 1 year with moderate to severe dehydration due to acute diarrhoea (1 child did not respond and needed intravenous therapy). Vomiting, abdominal distension, and appearance of sugar in the stools during oral hydration did not interfere with its success. A satisfactory response was shown by weight gain (mean +/- S.E. = 9-2 +/- 0-6%), restoration of plasma-bicarbonate to normal levels, falls in the haematocrit values and in the plasma specific gravity, and complete clinical recovery. Disaccharidases in jejunal mucosal biopsy specimens in the acute phase showed reduced lactase in 75% and reduced sucrase in 18%; maltase levels were adequate. Except for the child who did not respond, all showed a satisfactory rise of blood-sugar after sucrose and glucose tolerance tests. Sucrose is cheap and easily obtained; its use instead of glucose in electrolyte solutions would be a considerable gain.