Role of bicarbonate and base substances in treatment of acute gastroenteritis
Regardless of its aetiology, a dramatic decrease in the morbidity and mortality associated with childhood gastroenteritis have been seen due to widespread use of oral glucose-electrolyte rehydration solutions (ORS).
In developing countries, diarrhoeal disease continues to be the most common cause of death of children. More researchers making efforts for optimizing the effectiveness of ORS, because of its simplicity and economy. Different compositions of "ideal sodium and glucose" are now recommended in the developing and industrialized world. The addition of bicarbonate or a base substance (citrate, acetate, or lactate) in ORS is generally assumed to be necessary, both for increasing absorption of water and sodium and correction of acidosis.
Since early days, the use of oral rehydration solutions (ORS) has increased. Bicarbonate or a base substance is included in the World Health Organisation (WHO) ORS and in commercially manufactured ORSs throughout the world, on the premises that (a) bicarbonate enhances sodium and water absorption and (b) the metabolic acidosis of acute diarrhoea requires correction with exogenous base. Justification for the continued use of bicarbonate or base precursor in ORS must be supported by evidence for at least one or preferably both of these statements.
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