Rice-based oral rehydration solution decreases the stool volume in acute diarrhoea

Abstract

A ramdomized trial using oral rehydration solutions (ORS) with rice or glucose was carried out in 342 patients with acute watery diarrhea in the outpatient ward of the International Centre for Diarrheal Disease Research, Bangladesh, during an epidemic of cholera between December 1982-March 1983. On admission, 75% of these patients had severe dehydration and 70% were positive for Vibrio cholerae. There were 185 children aged under 10 years and 157 adults; 169 patients were treated with rice-ORS and 173 with glucose-ORS. Patients in both groups were comparable in age and body weight as well as the duration and severity of illness. Patients with severe dehydration were first rehydrated intravenously, and then treated with ORS. Those with moderate dehydration received ORS from the start. The mean stool output in the first 24 hours in children treated with rice-ORS was less than that in those treated with glucose-ORS (155 vs 204 ml/kg 24h; P0.01). The same was the case for the adult patients, the corresponding values for stool output being 115 versus 159 ml/kg24h (P0.05); the corresponding intakes in adult patients were, respectively, 180.5 and 247 ml/kg24 hours. A gain of about 10% of the body weight on admission was observed in all the groups. 6 cases (4 children and 2 adults) who failed to respond to oral rehydration after intravenous therapy all belonged to the glucose-ORS group. The study shows that, even under epidemic conditions of severe cholera or in cholera-like diarrhea, the glucose or sucrose solutions can be replaced by rice powder with improved results. Glucose and sucrose are manufactured products which are expensive and not always available in countries where diarrheal diseases are a problem. Rice, a staple food in many of these countries, reduces the fluid requirements when used in ORS and also provides increased nutrition even in the acute stage of illness