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Digestive Diseases and Sciences

, Volume 50, Issue 2, pp 241–245 | Cite as

Effect of Reducing Sodium or Glucose Concentration in a Hypo-osmolar ORS (Oral Rehydration Salts) on Absorption Efficiency: Marker Perfusion Study in Rat Jejunum

  • Manoj K. Chakrabarti
  • Kazi M. Haque
  • Manilal Chakrabarty
  • Dilip MahalanabisEmail author
Article

We evaluated the relative absorption efficiency of reducing the sodium or glucose concentration to make an ORS hypo-osmolar in a perfusion model. In nine adult albino rats 30 cm of jejunum was perfused at 0.4 ml/min with three glucose salt solutions for 45 min each, one with 60 mM sodium, 111 mM glucose, and osmolarity 247, one with 90 mM sodium, 60 mM glucose, and osmolarity 250, and one with 90 mM sodium, (111 mM) glucose, and osmolarity 301 (control solution). Each contained 2 g/L polyethylene glycol 4000 as a marker. The net water and sodium absorption were 2.8 (P < 0.001) and 2.6 (P < 0.001) times higher from low-sodium and 1.7 (P < 0.001)- and 1.5 (P < 0.001)-fold higher from low-glucose solutions compared to the control. Net glucose absorption was 2.2 (P < 0.001)-fold higher from low-sodium solutions compared to the control. The net water, sodium, potassium, and glucose absorptions were 1.6 (P < 0.001)-, 1.7 (P < 0.001)-, 1.36 (P < 0.05)-, and 4.15 (P < 0.001)-fold higher from low-sodium compared to low-glucose solutions. The hypo-osmolar ORS with reduced sodium was substantially more absorption efficient compared to the one with reduced glucose.

KEY WORDS

hypo-osmolar oral rehydration salts (ORS) jejunal absorption osmotic gradient concentration gradient ORS and sodium concentration ORS and glucose concentration marker perfusion technique rat jejunum 

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References

  1. UNICEF: The State of the World’s Children. Oxford UNICEF, Oxford University Press, 1993, p 22Google Scholar
  2. WHO: The treatment of diarrhoea, a manual for physicians and other senior health workers. WHO/CDR/95.3, 1995Google Scholar
  3. Mahalanabis D: Current staus of oral rehydration as a strategy for the control of diarrhoeal diseases. Indian J Med Res 104:115–124, 1996PubMedGoogle Scholar
  4. Rautanen T, El-Radhi S, Vesikari T: Clinical experience with hypotonic oral rehydration solution in acute diarrhoea. Acta Paediatr 82:52–54, 1993PubMedCrossRefGoogle Scholar
  5. El-Mougi M, El-Akkad N, Hendawi A, Hussain M, Amer A, Fontaine O, Pierce NF: Is a low-osmolarity ORS solution more efficacious than stndard WHO ORS solution? J Paediatr Gastroenterol Nutr 19:83–86, 1994CrossRefGoogle Scholar
  6. International Study Group on Reduced Osmolarity ORS Solution: Multicentre evaluation of reduced-ormolarity oral rehydration salts solution. Lancet 345:282–285, 1995Google Scholar
  7. Mahalanabis D, Faruque ASG, Haque SS, Faruque SM: Hypotonic oral rehydration solution in acute diarrhoea: a controlled clinical trial. Acta Paediatr 84:289–293, 1995PubMedCrossRefGoogle Scholar
  8. Faruque ASG, Mahalanabis D, Hamadani JD, Zetterstrom R: Reduced osmolarity oral rehydration salt in cholera. Scand J Infect Dis 28:87–90, 1996PubMedCrossRefGoogle Scholar
  9. Santosham M, Fayad I, Abuzukri M, et al.: A double-blind clinical trial comparing World Health Organization oral rehydration solution with a reduced osmolarity solution containing equal amounts of sodium and glucose. J Pediatr 128:45–51, 1996Google Scholar
  10. Report of an ESPGAN Working Group: Recommendations for composition of oral rehydration solutions for the children of Europe. J Pediatr Gastroenterol Nutr 14:113–115, 1992Google Scholar
  11. Sandhu BK, Christobal FI, Brueton MJ: Optimizing oral rehydration solution composition in model systems: studies in normal mammalian small intestine. Acta Paediatr Scand Suppl 364:17–22, 1989PubMedCrossRefGoogle Scholar
  12. Farthing MJG: Disease-related animal models for optimizing oral rehydration solution composition. Acta Paediatr Scand Suppl 364:23–30, 1989PubMedCrossRefGoogle Scholar
  13. Elliot EJ: The role of human perfusion techniques in the assessment of oral rehydration solutions. Acta Paediatr Scand Suppl 364:31–39, 1989CrossRefGoogle Scholar
  14. Hunt JB, Thillainayagam AV, Salim AFM, et al.: Water and solute absorption from a new hypotonic oral rehydration solution: evaluation in human and animal perfusion models. Gut 33:1652–1659, 1992PubMedCrossRefGoogle Scholar
  15. McNeish AS, Ducker DA, Warren IF, Davies DP, Harran MJ, Hughes CA: The influence of gestational age and size on the absorption of D-xylose and D-glucose from the small intestine of the human neonate. In Development of Mammalian Absorptive Process. Ciba Found Symp 16–18(70):267–280, 1979Google Scholar
  16. Younoszaai MK: Jejunal absorption of hexose in infants and adults. J Pediatr 85:446–448, 1974CrossRefGoogle Scholar
  17. Patra FC, Mahalanabis D, Jalan KN: Stimulation of sodium and water absorption by sucrose in the rat small intestine. Acta Paediatr Scand 103–107, 1982Google Scholar
  18. Hyden SA: A turbidimetric method for determination of higher polyethylene glycols in biological materials. Ann R Agr Coll 22:139–145, 1955Google Scholar
  19. Sladen GE, Dawson AM: Interrelationship between the absorption of glucose, sodium, and water by the normal human jejunum. Clin Sci 36:119–132, 1969PubMedGoogle Scholar
  20. Fordtran JS: Stimulation of active and passive sodium absorption by sugars in the human jejunum. J Clin Invest 55:728–737, 1975PubMedCrossRefGoogle Scholar
  21. Pappenheimer JR, Reiss KZ: Contribution of solvent drag through intercellular junctions to absorption of nutrients by the small intestine of the rat. J Membr Biol 100:123–136, 1987PubMedCrossRefGoogle Scholar
  22. Hahn SK, Kim YJ, Garner P: Reduced osmolarity oral rehydration solution for treating dehydration due to diarrhoea in children: systematic review. Br Med J 323:81–85, 2001CrossRefGoogle Scholar
  23. WHO: Reduced osmolarity oral rehydration salts (ORS) formulation. A report from a meeting of experts: jointly organized by UNICEF and WHO. UNICEF House, New York, 18 July 2001, pp 8–10Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Manoj K. Chakrabarti
    • 1
    • 2
  • Kazi M. Haque
    • 1
  • Manilal Chakrabarty
    • 3
  • Dilip Mahalanabis
    • 1
    Email author
  1. 1.Society for Applied StudiesCalcuttaIndia
  2. 2.National Institute of Cholera and Enteric DiseasesCalcuttaIndia
  3. 3.Kothari Medical CentreCalcuttaIndia

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