PMID: 11698779
Issn Print: 0277-2116
Publication Date: 2001/10/01
Oral Rehydration: Toward a Real Solution
Alfredo Guarino; Fabio Albano; Stefano Guandalini
Excerpt
Infectious diarrhea is a leading cause of childhood death. Although in 1980, it accounted for as many as 5 million deaths, the last estimate in 1999 was 2.2 million deaths of adults and children. Such a spectacular decrease in mortality rate is largely because of the increasing use of oral rehydration solution (ORS) (1). However, acute gastroenteritis is a major problem worldwide, with two distinct patterns. In the so-called developing countries, acute gastroenteritis is a dramatic, often catastrophic, condition that may have an epidemic pattern and is associated with a high mortality rate, particularly in younger and malnourished infants. It therefore requires a combined effort to decrease the mortality rate and to prevent the spread of infectious agents, namely Vibrio cholerae. In developed countries, death of gastroenteritis is almost nonexistent, but gastroenteritis is associated with enormous costs either directly (medical expenses) or indirectly (loss of working days by the parents of sick children) because of the frequency of the disease (2).
The widespread use of ORS in diarrheal diseases has saved the lives of millions of adults and children with diarrhea. Oral rehydration solution has been called “the most important advance in this century”(3), and this remains so for the turn of the century. However, the ideal composition of ORS is a matter of controversy and heated debate. To gain a wider perspective on the “ideal” ORS, this review will briefly discuss the current understanding of pathophysiologic processes responsible for water and electrolyte absorption from the intestine and their modifications in diarrheal disease. It will then review available options and possible new developments.
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