Partially hydrolyzed guar gum-supplemented oral rehydration solution in the treatment of acute diarrhea in children.
BACKGROUND
Partially hydrolyzed guar gum (Benefiber; Novartis Nutrition, Minneapolis, MN, U.S.A.) is fermented by colonic bacteria liberating short-chain fatty acids (SCFAs), which accelerate colonic absorption of salt and water. The purpose of this study was to evaluate the effect of Benefiber (BF)-supplemented World Health Organization Oral Rehydration Solution (WHO ORS) in the treatment of acute noncholera diarrhea in children.


METHODS
A double-blind, randomized, controlled clinical trial was performed at ICDDR,B in 150 male children aged 4 to 18 months who had watery diarrhea of less than 48 hours' duration. After admission, children were assigned to receive either WHO ORS or BF-supplemented WHO ORS until recovery. Major outcome measures, such as duration of diarrhea and amount of stool output, were compared between the treatment groups.


RESULTS
Patients receiving BF-supplemented WHO ORS had significantly reduced duration of diarrhea compared with the control group (mean +/- SD, 74 +/- 37 vs. 90 +/- 50 hours, P = 0.03). Survival analysis for duration of diarrhea also showed a reduction the BF-supplemented WHO ORS-treated group (P = 0.025, log rank test). There was also less stool output daily from days 2 through 7 in the patients treated with BF-supplemented WHO ORS compared with that in the children treated with WHO ORS; the reduction was significant on day 7 only.


CONCLUSIONS
Benefiber added to standard WHO ORS substantially reduces the duration of diarrhea and modestly reduced stool output in acute noncholera diarrhea in young children, indicating its potential as a new antidiarrheal therapy for acute diarrhea in children.
Alam
N H
NH
Clinical Sciences Division, ICDDR,B, Centre for Health and Population Research, Dhaka, Bangladesh. nhalam@icddrb.org
Meier
R
R
Schneider
H
H
Sarker
S A
SA
Bardhan
P K
PK
Mahalanabis
D
D
Fuchs
G J
GJ
Gyr
N
N
D000208:Acute Disease; D000930:Antidiarrheals / Q000627:therapeutic use; D001459:Bangladesh; D003968:Diarrhea, Infantile / Q000628:therapy*; D004311:Double-Blind Method; D005243:Feces; D005440:Fluid Therapy / Q000379:methods*; D005685:Galactans / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D008351:Mannans / Q000008:administration & dosage / Q000627:therapeutic use*; D053149:Plant Gums; D015532:Rehydration Solutions / Q000737:chemistry / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014944:World Health Organization
D000930:Antidiarrheals; D005685:Galactans; D008351:Mannans; D053149:Plant Gums; D015532:Rehydration Solutions; C007894:guar gum