Rehydration Solutions?

The norovirus has been in the news lately thanks to outbreaks at local schools and on a few cruise ships. As people recover from this illness the focus is often on rehdyration (replacing fluid loss from diarrhea and/or vomiting) as well as electrolyte replacement (replacing sodium and potassium lost from diarrhea and/or vomiting). You also want to make sure that the beverages that you use don't aggravate any nausea or diarrhea that you might currently have and make sure that the solution can be absorbed by the digestive system efficiently. Of course many people who are feeling terrible (or feeling stressed from caring for an ill person) will reach for what is readily available, which is often a sports drink such as Gatorade or Powerade or even just a regular sugary drink like a soft drink or kool-aid. But are these really the best things to offer for oral rehydration therapy after severe illness?

 

The evidence points to the answer being no for a variety of different reasons. First of all, the sports drinks like Gatorade may have enough sodium/potassium to replace sweat losses but not to replace losses from protracted/frequent vomiting and diarrhea. Second of all, the amount of sugar in sports drinks, and some sodas/sugar beverages, causes them to have a 

high-osmolarity and can actually cause diarrhea and therefore more fluid/electrolyte losses. Third, sugary drinks like sodas also don't have the sodium and potassium needed to replace electrolyte losses. Fourth, some of the carbonated beverages might cause more stomach distension and promote that nauseated feeling.

 

A better option would be to choose a solution formulated to have the right amount of sodium, potassium and glucose (sugar) such as Pedialyte. For those of you who want to have additional control over the taste and flavoring of the solution, you can also make your own oral rehydration solution using this recipe used by the World Health Organization:

2 level Tablespoons (TBSP) of sugar

½ level teaspoon (tsp) of table salt (sodium chloride)

½ level teaspoon (tsp) of salt substitute such as No Salt (potassium chloride)

½ level teaspoon (tsp) of baking soda, dissolved into

4¼ cups (1 liter) of clean water

Add your favorite sugar free beverage mix to improve the taste.

All that said, an oral rehydration solution is only useful if to the sick person if he/she is willing to drink it.  (One of my co-workers told me a story about how his cranky toddler threw a Pedialyte popsicle at him after tasting it).  So you might be better off mixing your own where you can control the taste.
 
Also:

• You might be able to to get away with using Gatorade, etc if your diarrhea/vomiting was very mild.
• Infants, frail elderly, and those who are immunocompromised are at a higher risk for dehydration and may need medical care.
• If you show signs of severe dehydration you need to seek medical care.

Take home message--A commercial rehydration solution such as Pedialyte or a homemade solution is more appropriate for rehydration after suffering losses from severe diarrhea and/or vomiting.