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Oral Rehydration for Viral Gastroenteritis in Adults: A Randomized, Controlled Trial of 3 Solutions

S. S. C. Rao, MD, PhD, FRCP^*, R. W. Summers, MD^*, G. R. S. Rao, MD, S. Ramana, MD, U. Devi, DM, B. Zimmerman, PhD and B. C. V. Pratap, DM

From the ^* Department of Internal Medicine and Department of Biostatistics, University of Iowa, Iowa City, Iowa; and the Department of Gastroenterology and Infectious Disease, Osmania Medical College, and Sir Ronald Ross Institute of Tropical Medicine and Infectious Diseases, Hyderabad, India

Correspondence: Satish S. C. Rao, MD, PhD, FRCP, 4612 JCP, University of Iowa Hospitals, 200 Hawkins Drive, Iowa City, IA 52242-1009. Electronic mail may be sent to satish-rao{at}uiowa.edu.

Background: Pedialyte and Gatorade are advocated for the treatment of dehydration in viral gastroenteritis, but there is limited evidence to support their use. We examine the efficacy, safety, and palatability of Pedialyte, Gatorade, and a New Oral Rehydration Solution (N-ORS). This was a randomized double-blind trial conducted in an inpatient, community hospital. Seventy-five consecutive adult patients (male, 42; female, 33) admitted with viral gastroenteritis were randomized to receive Gatorade, Pedialyte, or N-ORS for 48 hours. A yogurt/rice diet was allowed ad libitum. Stool and urine output, electrolytes, fluid intake, body weight, hematocrit, and palatability of solutions were measured. Results: Sixty completed the study. Stool frequency, consistency, and body weight improved (p < .001) in all 3 groups, but there was no difference between groups. Likewise, urine output, hematocrit, and correlations between fluid ingested, stool weight, or urine output were similar. At admission and 24 and 48 hours later, hypokalemia was observed in 7, 10, and 8 patients with Gatorade; 3, 2, and 1 with N-ORS; and 2, 2, and 1 with Pedialyte, respectively. Similarly, hyponatremia was observed in 6, 9, and 3 patients with Gatorade; 5, 3, and 4 with N-ORS; and 4, 5, and 4 with Pedialyte. Tastewise, Gatorade and N-ORS were rated higher (p < .05) than Pedialyte. Limitations were a smaller sample size and higher dropout (20%). Conclusions: Gatorade and N-ORS seem to be as effective as Pedialyte in correcting dehydration and in improving bowel symptoms. All 3 solutions were safe. Unlike other groups, hypokalemia persisted in the Gatorade group. Gatorade and N-ORS may be effective in the treatment of dehydration associated with mild viral gastroenteritis.

Journal of Parenteral and Enteral Nutrition, Vol. 30, No. 5, 433-439 (2006)
DOI: 10.1177/0148607106030005433


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