Replacement of Water and Electrolyte Losses in Cholera by an Oral Glucose—Electrolyte Solution

The efficacy of an orally administered glucose-electrolyte solution in replacing stool losses of water and electrolytes in severe cholera was evaluated. After initial intravenous rehydration intravenous fluids were discontinued, and subsequent water and electrolyte losses were replaced by the oral solution administered via nasogastric tube. In 9 of 10 patients so treated, water, electrolyte, and acid-base balances were adequately maintained by this method until diarrhea ended. One patient with very severe diarrhea required small amounts of additional intravenous fluids to maintain water balance. Patients receiving the oral solution had a small but significant increase in stool output during oral fluid administration when compared with the 10 patients in the control group who received only intravenous replacement of stool losses. Calculated absorption of the oral fluid was 87%. Duration of diarrhea and of Vibrio cholerae excretion were not prolonged by the oral solution administration. The role of glucose in the absorption of water and sodium by the small bowel is discussed. The study suggests a useful role for such an orally administered glucose-electrolyte solution in the management of cholera.