Rice-based oral electrolyte solutions for the management of infantile diarrhea

Article Abstract:

Although oral glucose solutions designed to treat dehydration in infants and children suffering from acute diarrhea are effective in restoring the body's normal water balance, they do not lessen the severity of diarrhea. This is because they do not increase the resorption of fluid secreted by the intestinal cells themselves; their action is concentrated instead on absorption of the material within the lumen of the intestine. A product that both increases fluid absorption and reduces diarrhea would have advantages over currently available preparations. Two rice-based oral rehydration solutions with both antidiarrheal and anti-dehydration effects were tested in 86 male infants (between 3 and 18 months of age) with mild or moderate dehydration who entered a hospital in Costa Rica. The infants had experienced acute diarrhea of seven or fewer days' duration. They were randomly assigned to receive solutions containing rice-syrup solids and sodium (group A, 30 infants); rice-syrup solids and sodium plus casein hydrolysate (group B, 27); or a commercial rehydration solution containing sodium and glucose (group C, 29). The state of hydration of each infant was determined on admission to the hospital and again after treatment by the test solution (by bottle or tube feeding). Infants' weights, fluid intake and output, and electrolyte levels were determined; blood tests and cultures from stool specimens were performed. Results showed that both rice-based solutions were more effective than the glucose-based formulation: the fecal output of group A and B infants was lower than of group C infants (25 and 45 percent less, respectively). Fluid absorption for group A infants was greater than for infants in the other groups, and these infants absorbed the most potassium during the first six hours of treatment. Group B infants vomited more than those in group A (a means of fluid loss). Sodium balance was similar in all three groups. While all three solutions were effective in controlling dehydration, the rice-syrup preparation without casein hydrolysate was best at restoring water and potassium balance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, International aspects, Costa Rica, Composition, Electrolyte solutions, Diarrhea in children, Childhood diarrhea, Diarrhea, Infantile

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Magnesium-induced diarrhea and new insights into the pathobiology of diarrhea

Article Abstract:

There are many different substances that can cause diarrhea and they affect the intestines in different ways. Bacteria, toxins, chemicals and laxatives are all capable of causing diarrhea. Previous studies have shown that ingestion of large amounts of magnesium, in the form of antacids or laxatives, can cause diarrhea, and that continuous overuse of laxatives can cause chronic diarrhea. There are four basic types of laxatives: osmotic (those that cause an increase in the volume of the intestinal contents, causing the intestines to empty), bulk-forming (those containing substances that are not digestible), stimulants (those that directly affect the cells lining the intestine) and stool softeners (lubricants that aid the passage of stools). Magnesium is called an osmotic laxative and can be found in Maalox, Mylanta, Gelusil and mineral supplements. Most of the methods available for diagnosing the cause of diarrhea involve analyzing stool samples for water content, mineral content, and weight, and these methods are not always conclusive. A recent study, published in the April 11, 1991 issue of the New England Journal of Medicine, reported the development of a diagnostic test for diarrhea caused by magnesium. The test involves measuring the amount of magnesium present in stool samples. The results of this study showed that patients with normal stools and those with diarrhea induced experimentally with substances other than magnesium, contained very low levels of magnesium. However, when diarrhea was induced by consuming a beverage containing large amounts of magnesium, the stool samples contained high levels of magnesium. Also, an evaluation of 35 patients with chronic diarrhea of unknown cause revealed that 21 of the patients had higher than normal levels of magnesium in their stools, and that 15 of these patients were taking laxatives containing magnesium. Future studies directed toward identifying potential causes of diarrhea and how these substances act in the intestines will increase the understanding or inflammatory bowel diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Physiological aspects, Magnesium, Magnesium (Metal), editorial, Maalox (Medication), Mylanta (Medication), Gelusil (Medication)

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Evaluation of patients with chronic diarrhea

Article Abstract:

Chronic diarrhea is diarrhea that has lasted for more than four weeks. This automatically eliminates most infectious causes of diarrhea. The most common causes of chronic diarrhea are chronic infection, inflammatory bowel diseases, malabsorption, and drugs such as laxatives. The initial work-up should include tests of stool samples, X-rays of the abdomen and endoscopic examination of the gastrointestinal tract. Additional tests include tests for specific infectious agents, urine analysis, CT scans of the abdomen, and gastrointestinal biopsies. If these tests are normal, the patient should be hospitalized and considered to have diarrhea of undetermined origin. Laxative abuse is the most common cause of this type of diarrhea. If diarrhea stops after a 72-hour fast, it is clearly of dietary origin. Laxative abuse or malabsorption are the most likely causes. Ninety percent of patients with chronic diarrhea can be diagnosed following an extensive work-up.

Diagnosis

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