ºÚÁϳԹÏÍø

HomeThe PCMC Journalvol. 17 no. 1 (2021)

A Systematic Review and Meta-Analysis on Effectiveness of Rice-Based Oral Rehydrating Solution for the Treatment of Acute Watery Diarrhea among Children

Mercellaine Marie S. Mangahas | Michael M. Resurreccion

Discipline: medicine by specialism

 

Abstract:

OBJECTIVES: This study aims to compare the effectiveness of rice-based ORS as compared with glucose-based ORS in the treatment of acute watery diarrhea among children. Specifically, it aims to review and analyze the effectiveness of rice-based ORS as compared to glucose-based ORS as to stool output, duration of diarrhea and effect of osmolarity on treatment of diarrhea and to determine associated adverse events associated with rice-based ORS and glucose-based ORS. METHOD: This study used systemic review and meta-analysis of randomized trials. Primary outcomes were computed with 95% confidence intervals to determine the effectiveness of rice-based ORS. Adverse event was expressed as risk ratios with 95% confidence intervals. RESULTS: Sixteen studies met the criteria for the systematic review and meta-analysis. Duration of acute diarrhea was shorter by 5 hours with rice-based ORS (MD= −5.27 hours, 95% CI= −9.63 to −0.91, p-value= 0.02) compared to glucose-based ORS. The stool output was 62.35 mL/kg lower with rice-based ORS (MD= −62.35 mL/kg, 95%CI= −128.43 to 3.74, p-value= 0.06) compared to glucose-based ORS. Vomiting was the only reported associated event with ORS intake (RR= 1.08, 95%CI= 0.81to 1.43, p-value= 0.60). CONCLUSION: Sixteen studies met the criteria for the systematic review and meta-analysis. Duration of acute diarrhea was shorter by 5 hours with rice-based ORS (MD= −5.27 hours, 95% CI= −9.63 to −0.91, p-value= 0.02) compared to glucose-based ORS. The stool output was 62.35 mL/kg lower with rice-based ORS (MD= −62.35 mL/kg, 95%CI= −128.43 to 3.74, p-value= 0.06) compared to glucose-based ORS. Vomiting was the only reported associated event with ORS intake (RR= 1.08, 95%CI= 0.81to 1.43, p-value= 0.60).



References:

  1. World Health Organization (2017). Diarrheal disease [Fact Sheet]. Retrieved from
  2. Global Burden of Diseases 2016 Diarrheal Diseases Collaborators: Lancet Infectious Diseases 2018, 18: 1211-28.
  3. Global Burden of Diseases Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME, 2018).
  4. World Health Organization. Oral Rehydration Salts (ORS) a New Reduced Osmolarity Formulation – Joint WHO/UNICEF, Expert consultation on oral rehydration salts formulation – UNICEF House, New York, USA, 28 July, 2001. Retrieved from https://rehydrate.org/ors/expert-consultation.html.
  5. Brandt, KG, de Castro Antunes, MM & da Silva, GA. (2015). Acute diarrhea: evidence-based management. J. Pediatr. (Rio J.) 2015; 91(6) 36 - 43.
  6. Santosham, M, Burns, BA, & Reid, R, et al. (1986). Glycine-based oral rehydration solution: reassessment of safety and efficacy. Journal of Pediatrics. 1986; 109 (5): 795-801.
  7. Bhan, MK, Sazawal, S, Bhatnagar, S, Bhandari, N, Guha, DK, & Aggarwal, SK. (1990). Glycine, glycyl-glycine and maltodextrin based oral rehydration solution. Assessment of efficacy and safety in comparison to standard ORS. Acta Paediatrica Scandinavia. 1990;79(5):518-526.
  8. Carson, RA, Mudd, SS, & Madati, PJ. (2016). Clinical Practice Guideline for the Treatment of Pediatric Acute Gastroenteritis in the Outpatient Setting. Journal of Pediatric Health Care. 2016. 30(6) 610-616.
  9. Gregorio, GV, Gonzales, ML, Dans, LF, & Martinez, EG. (2016). Polymer-based oral rehydration solution for treating acute watery diarrhoea. Cochrane Database Syst Rev. 2016;12(12):CD006519. Published 2016 Dec 13. doi:10.1002/14651858.CD006519.pub3
  10. Fontaine, O, Gore, SM, & Pierce, NF. (1998). Rice-based oral rehydration solution for treating diarrhea. Cochrane Database of Systematic Reviews 1998, Issue 4. Art No. CD001264. DOI: 10.1002/14651858.CD001264.pub2.
  11. Faruque, A, Hoque, S, Fuchs, G, & Mahalanabis, D. (1997). Randomized, controlled, clinical trial of rice versus glucose oral rehydration solutions in infants and young children with acute watery diarrhoea. Acta Paediatrica, 86(12), 1308-1311. doi: 10.1111/j.1651-2227.1997.tb14903.
  12. Patra, F., Mahalanabis, D., Jalan, K., Sen, A. and Banerjee, P., 1982. Is oral rice electrolyte solution superior to glucose electrolyte solution in infantile diarrhoea? Archives of Disease in Childhood, 57(12), pp.910-912.