title: Thermophilic amylase-digested rice-electrolyte solution in the treatment of acute diarrhea in children.
abstract: OBJECTIVE
  To compare the efficacy of an oral rehydration solution (ORS) containing short polymers of glucose derived from rice (Amylyte-ORS) and five times the caloric density of current ORS to the standard glucose-ORS (World Health Organization [WHO] = ORS) in the treatment of acute diarrhea in children.
  
  
  METHODS
  The rice ORS (Amylyte-ORS) was obtained by adding thermophilic amylase (252,500 MW units) and salts (1.5 g NaCl, 600 mg KCl, and 150 mg CaCl2) to 100 g rice and boiling for 10 minutes in 500 mL water. This yields 250 mL Amylyte-ORS, which contains 92% to 96% short-chain glucose polymers, three to nine molecules in length, and provides 425 kcal/L, compared to 80 kcal/L for the WHO-ORS. One hundred forty-four male children, 4 months to 3 years of age, presenting with acute diarrhea and mild, moderate, or severe dehydration, were assigned by random allocation to receive either WHO-ORS or Amylyte-ORS. Data from 127 children were analyzed (57 received the WHO-ORS and 70 the Amylyte-ORS). Two children given Amylyte-ORS and 15 given the WHO-ORS were not included in the analysis because of improperly collected data or lost urine or fecal specimens. None were given antibiotics during the study. Free water and feeding were allowed after the children were rehydrated.
  
  
  RESULTS
  The clinical characteristics of the children in the two treatment groups were comparable. Five children who received the WHO-ORS and three children given Amylyte-ORS were treatment failures. Amylyte-ORS reduced diarrhea duration by 15% (41.4 +/- 2.5 vs 34.7 +/- 1.8 hours; P < .03) compared to the WHO-ORS, regardless of the severity of dehydration. In the Amylyte-treated group, ORS requirements were significantly less (234 +/- 15.2 vs 295 +/- 17.6 mL/kg; P < .01) and weight gain was significantly more (367.7 +/- 45.1 vs 199.2 +/- 38.2 g; P < .01) than in those given the WHO-ORS. The net intestinal fluid balance and total body fluid balance were similar in the two groups.
  
  
  CONCLUSIONS
  Amylyte-ORS effectively rehydrates children with acute diarrhea, reduces diarrhea duration, decreases ORS requirements, and improves weight gain compared to the WHO-ORS.
authors.affiliation: Department of Pediatrics, International Institute for Infant Nutrition and Gastrointestinal Disease, Mount Scopus, Hadassh-Hebrew University Medical Center, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Lebenthal
authors.lastname: Khin-Maung-U
authors.forename: D D
authors.initials: DD
authors.lastname: Rolston
authors.lastname: Khin-Myat-Tun
authors.lastname: Tin-Nu-Swe
authors.lastname: Thein-Thein-Myint
authors.forename: P
authors.initials: P
authors.lastname: Jirapinyo
authors.forename: N
authors.initials: N
authors.lastname: Visitsuntorn
authors.forename: A
authors.initials: A
authors.lastname: Firmansyah
authors.forename: S
authors.initials: S
authors.lastname: Sunoto
mesh_terms: D000208:Acute Disease; D000681:Amylases; D001639:Bicarbonates / Q000737:chemistry / Q000627:therapeutic use; D002675:Child, Preschool; D003681:Dehydration / Q000628:therapy*; D003967:Diarrhea / Q000628:therapy*; D003968:Diarrhea, Infantile / Q000628:therapy*; D005440:Fluid Therapy; D005947:Glucose / Q000737:chemistry / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D012275:Oryza; D011189:Potassium Chloride / Q000737:chemistry / Q000627:therapeutic use; D015532:Rehydration Solutions / Q000737:chemistry / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000737:chemistry / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance; D015430:Weight Gain
chemical_list: D001639:Bicarbonates; D015532:Rehydration Solutions; C044142:World Health Organization oral rehydration solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D000681:Amylases; D005947:Glucose