Williams, J.; Dart, J.; Van Heel, D.; Travis, S.P.L.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA10
Academic Journal
Background: Isotonic oral rehydration solutions (ORS[ facilitate nutritional management of short bowel syndrome (SBS) and ileostomy dysfunction by reducing stoma output and improving hydration. Maximal intestinal Na+ and water absorption occurs at [Na[sup +]] 90-120 mmol/L and is facilitated by glucose. Patient compliance with IORS is poor but can be improved by the addition of flavourings such as fruit juice or squash. Amounts are unspecified and the effect of adding flavouring on the solution biochemistry has not been established. Aim: To determine the effect on INa[sup +]], [glucose] and osmolality, after the addition of fruit juice or squash as flavouring components to IORS. Method: John Radcliffe Hospital (JRH) prepared ORS and 15 commercial sports/energy drinks were analysed for [Na[sup +]], [glucose], and osmolality by standard biochemical techniques. The JRH IORS prepared solutions were: (a) 200 mi no added sugar (NAS) squash + 800 mi H[sub 2]O + 1 metric teaspoon NaCI; [b) 200 mi regular squash + 800 mi H[sub 2]O + 1 metric teaspoon NaCI; [c) 750 mi fruit juice + 250 mi H[sub 2]O + 1 metric teaspoon NaCI; and (d) 1000 mi Lucozade Sport and 1 metric teaspoon NaCl. A variety of sports/energy drinks were analysed. Conclusion: None of the commercial solutions had adequate INa[sup +]] (range < 20-30 mmol/L); they were on average hyperosmolar (range 335-1031 mOsm; median 595 mOsm) and had variable, mostly high glucose concentrations (range 10.6-655.7 mmol/L; median 190 mmol/L). Flavouring with fruit juice or squash made IORS hypertonic, therefore rendering them less suitable in managing SBS. All JRH IORS conta ned adequate [Na[sup +]] (> 90 mmol/L) but the addition of 200 ml NAS squash was the only one to remain isoosmolar after flavouring.


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