Abstract

PIP: Much clinical experience has been gained in the use of the glucose/electrolyte oral solutions in the treatment of acute diarrhea. Those patients who are in shock or too weak to drink need intravenous fluids to correct their total deficit. With isotonic polyelectrolyte fluids rehydration may be achieved in 2-4 hours. Subsequently, most of these patients can be given oral fluids to replace continuing stool loss. Patients who are not in shock and who are sufficiently strong to drink at the outset nearly always can be rehydrated with oral fluids alone. Vomiting is most likely caused by acidosis and volume depletion, and these can be corrected in severely dehydrated patients by intravenous therapy and by oral therapy in those not in shock and able to drink by oral therapy. Proponents of oral glucose/electrolyte therapy for diarrhea, like other proponents of new treatments, have great visions of its benefits to the world, yet these visions require validation. The biggest problem will be getting glucose and electrolytes to where they are most needed -- at the level of home and village.