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Background: Radiotherapy inadvertently affects gastrointestinal (GI) epithelial cells, causing intestinal barrier disruption and increased permeability., Objective: We examined the effect of amino acid-based oral rehydration solution (AA-ORS) on radiation-induced changes of intestinal barrier function and epithelial tight junctions (TJs) in a randomized experimental study using a total-body irradiation (TBI) mouse model., Methods: Eight-week-old male Swiss mice received a single-dose TBI (0, 1, 3, or 5 Gy), and subsequent gastric gavage with AA-ORS (threonine, valine, serine, tyrosine, and aspartic acid) or saline for 2 or 6 d. Intestinal barrier function of mouse ileum was characterized by electrophysiological analysis of conductance, anion selectivity, and paracellular permeability [fluorescein isothiocyanate (FITC)-dextran]. Ultrastructural changes of TJs were evaluated by transmission electron microscopy. Membrane protein and mRNA expression of claudin-1, -2, -3, -5, and -7, occludin, and E-cadherin were analyzed with western blot, qPCR, and immunohistochemistry. Nonparametric tests were used to compare treatment-dose differences for each time point., Results: Saline-treated mice had a higher conductance at doses as low as 3 Gy, and as early as 2 d post-TBI compared with 0 Gy (P < 0.001). Paracellular permeability and dilution potential were increased 6 d after 5 Gy TBI (P < 0.001). Conductance decreased with AA-ORS after 2 d in 3-Gy and 5-Gy mice (P < 0.05 and P < 0.001), and on day 6 after 5 Gy TBI (P < 0.001). Anion selectivity and FITC permeability decreased from 0.73 ± 0.02 to 0.61 ± 0.03 pCl/pNa (P < 0.01) and from 2.7 ± 0.1 × 105 to 2.1 ± 0.1 × 105 RFU (P < 0.001) in 5-Gy mice treated with AA-ORS for 6 d compared with saline. Irradiation-induced ultrastructural changes of TJs characterized by decreased electron density and gap formation improved with AA-ORS. Reduced claudin-1, -3, and -7 membrane expression after TBI recovered with AA-ORS within 6 d, whereas claudin-2 decreased indicating restitution of TJ proteins., Conclusions: Radiation-induced functional and structural disruption of the intestinal barrier in mice is reversed by AA-ORS rendering AA-ORS a potential treatment option in prospective clinical trials in patients with gastrointestinal barrier dysfunction., (Copyright © The Author(s) 2020.)

Both gelatin and pectin have the ability to trap salt and facilitate its release under simulated gastric conditions. The objective of this study was to develop a pectin-gelatin gel fortified with oral rehydration solution/s (ORS) that can maintain a more rigid structure to limit salt mobility (potentially less salty taste), yet allow rapid release in simulated gastric conditions. Two gels containing both pectin and gelatin were developed: (1) low salt (LS) containing 2.6 g/L salt and 13.5 g/L sugar and (2) high salt (HS) containing 5.2 g/L salt and 27.0 g/L sugar. The ORS-fortified gels were compared with commercially available gelatin gels and a control pectin-gelatin gel without added salt or sugar. A stronger gel network (higher G') and higher viscosity was noted for HS compared to other samples. HS had slower salt release (80.70 ± 1.92%) than LS (95.95 ± 3.82%) at 1 min in simulated gastric conditions. After 120 min, HS showed up to 99.38 ± 1.08% release of salt, while LS had 95.95 ± 3.82% release. HS had a favorable textural profile, having values more similar to the ready-to-eat commercial cup gel than did the LS formulation. The HS formulation resulted in a stable structure for ORS delivery and beneficial release properties., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Aim: The aim of this study was to investigate oral rehydration therapy (ORT) products and their effect on plaque pH under normal and dry mouth conditions., Design: Three commercial oral rehydration therapy products, prepared according to the manufacturers' instruction, plus a 10% glucose solution, which served as control, were tested in 10 healthy subjects (mean age 25 years): (1) Electral (Arrow Pharmaceuticals), (2) Resorb Junior (Nestlé) and (3) Vätskeersättning (Semper). pH was measured in the maxillary premolar region in situ with the so-called microtouch method. The area under the pH curve was calculated. Their carbohydrate content was also analysed., Results: The oral rehydration therapy products gave the same low pH values in plaque as the glucose solution. Dry mouth condition, obtained by injection of methylscopolamine nitrate in the labial sulcus, resulted in an overall more pronounced fall in pH and in a delay in the pH recovery compared with normal salivary conditions. The chemical analyses showed that all three test-products contained glucose and starch as the main carbohydrates., Conclusions: Rinsing with oral rehydration therapy products leads to a greater pH decrease in dental plaque during low compared with normal salivary conditions. As diarrhoea may result in dehydration and thereby in dry mouth, we believe that ORT products have a high cariogenic potential., (© 2013 FDI World Dental Federation.)

In this review, the relative merits of the different fluid solutions used for fluid replacement will be discussed. Differences in chemical composition may have important implications on volume expansion capacities but also on organ function. Among crystalloids, differences in electrolyte composition, and in particular chloride load, alter acid base status but may also affect other aspects of organ function. Large observational cohorts suggest that chloride load may be associated with a poor outcome. Colloids provide greater expansion capacities than crystalloids. When colloids are indicated, albumin should be preferred as it is the only one that has been proved to be safe in a large randomized trial. Cumulative evidence suggests that starches, even of the new generations, are associated with development of acute kidney injury. Hypertonic solutions may represent an interesting option in some groups of patients but more research is needed in this field., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Discovery of intestinal sodium-glucose transport was the basis for development of oral rehydration solution, and was hailed as potentially the most important medical advance of the 20th century. Before widespread use of oral rehydration solution, treatment for diarrhoea was restricted to intravenous fluid replacement, for which patients had to go to a health-care facility to access appropriate equipment. These facilities were usually neither available nor reasonable to use in the resource-poor settings most affected by diarrhoea. Use of oral rehydration solution has stagnated, despite being effective, inexpensive, and widely available. Thus, diarrhoea continues to be a leading cause of child death with consistent mortality rates during the past 5 years. New methods for prevention, management, and treatment of diarrhoea-including an improved oral rehydration formulation, zinc supplementation, and rotavirus vaccines-make now the time to revitalise efforts to reduce diarrhoea mortality worldwide., (Copyright 2010 Elsevier Ltd. All rights reserved.)

Sugar-based Oral Rehydration Therapy (ORT) is still the conventional treatment for diarrhoeal diseases. The WHO/UNICEF, and other groups endorse and actively promote its use for all cases of diarrhoea. Despite the deleterious effects of sugars promotion on dental health, and the incontrovertible role of sugars as the major factor responsible for the present upsurge in dental caries prevalence in the developing countries, the search for an ideal Oral Rehydration Solution (ORS) has so far completely ignored any dental considerations. Of the presently available rehydration solutions, the cereal or food-based solutions offer greater advantages over the sugar based solutions. Further research efforts must be directed at non-sugar based ORT, and funding organisations should give support to researchers and research institutions working to replace sugars with cereal flours, improve food-based ORS, or develop novel approaches to ORT that are based on non-cariogenic ingredients. Policy makers, researchers and health care workers generally must always consider, in addition to other factors, the dental implications of their recommendations on ORT.

Oral rehydration therapy (ORT) has dramatically reduced the morbidity and mortality associated with acute infectious diarrhea. Commercial oral rehydration salt (ORS) solutions with sodium concentrations of 30-90 mmol/L are ideal for both the prevention and treatment of dehydration. However, logistic issues impede their universal availability and homemade sugar salt (HSS) solutions are widely used in some areas of the world. The least accurate methods of preparing HSS solutions utilize a three-finger pinch of salt. The present study demonstrates the inconsistency and inaccuracy of this method among 15 health workers who participated in an ORT training seminar conducted in a situation that approximated field conditions. Similar studies with different subjects, instructions, and milieu describe results similar to those we obtained. In all studies, including the present one, a substantial number of the solutions prepared by this method had dangerously high or low sodium concentrations. Health providers should consider the use of selected home-available fluids rather than HSS solutions for the prevention of dehydration in children with diarrhea. However, ORS solutions should be used to correct established dehydration.

In developed countries, use of oral rehydration salts (ORS) solution with osmolarity lower than that of plasma has been recommended because of the risk of hypernatraemia. We compared the clinical efficacy of reduced-osmolarity ORS and standard ORS solutions in children with acute diarrhoea in four developing countries. 447 boys aged 1-24 months, admitted to hospitals in four countries with acute diarrhoea and signs of dehydration, were randomly assigned either standard ORS (311 mmol/L) or reduced-osmolarity ORS (224 mmol/L) solution. Total stool output was 39% greater (95% CI 11-75), total ORS intake 18% greater (3-33), and duration of diarrhoea 22% longer (2-45) in the standard ORS group than in the reduced-osmolarity ORS group. The risk of requiring intravenous infusion after completion of the initial oral rehydration was greater in children given standard ORS solution than in those given reduced-osmolarity ORS solution in three of the four countries (all-country relative risk 1.4 [0.9-2.4]). This relative risk was significantly increased only in non-breastfed children (2.0 [1.0-3.8], p < 0.05). In breastfed children, the relative risk of requiring intravenous infusion was not affected by the ORS solution (0.9 [0.4-2.0]). The mean sodium concentration 24 h after admission was significantly lower in the reduced-osmolarity ORS group than in the standard ORS group (135 [134-136] vs 138 [136-139] mmol/L, p < 0.01). Reduced-osmolarity ORS solution has beneficial effects on the clinical course of acute diarrhoea. Our findings support the use of reduced-osmolarity ORS solution in children with acute non-cholera diarrhoea in developing countries. Further studies are needed to find the best formulation and whether such a solution would be satisfactory for the treatment of cholera.