Oral or nasogastric maintenance therapy for diarrhoea of unknown aetiology resembling cholera

Abstract

Clinical trials under field hospital conditions were undertaken in India and Pakistan to determine the efficacy of oral maintenance solutions in treatment of noncholera diarrheal patients. Those patients with severe dehydration due to diarrhea were 1st rehydrated with a standard intravenous solution until the blood pressure was normal. They were then administered a warmed maintenance solution by mouth or nasogastric tube. Milder cases were given only an oral solution. The oral treatment was found to maintain fluid balance in all cases. Oral electrolyte solutions containing both glucose and glycine produced lower total stool volumes than the solutions made up only of electrolytes and glucose. The addition of glycine to the solution seems to enhance absorption. This oral therapy is recommended because the solution is cheap and the ingredients are widely available. Both solutions eliminated the need for intravenous fluids in 80% of the cases, thus lowering the number of staff man-hours needed per patient. This treatment can, thus, lower total costs and increase availability of diarrhea treatment in developing countries where severe diarrheal diseases are common.