[Management of acute diarrheal disease with rice water].

A prospective study was conducted in late 1990 of 60 children aged 3-35 months to compare management of light to moderate dehydration from acute diarrhea using World Health Organization oral rehydration solution (ORS) or rice water. Rice water, the liquid obtained by draining rice after cooking, has the nutritional advantage of providing more calories during rehydration than does ORS and the osmolar advantage that its carbohydrates are released gradually in the intestine. 30 children were rehydrated with rice water and 30 with ORS. The rice water was prepared in the manner typical of mothers in the Dominican Republic as revealed by a recent survey. Mildly dehydrated patients were given 50 ml/kg of either rice water or ORS and those with moderate dehydration were given 100 ml/kg. Patients were monitored during the 4-6 hours of treatment and returned 24 hours later for evaluation. Serum sodium levels were measured on admission and after 4 hours of treatment. The two groups of infants were similar in age, sex, duration and severity of diarrhea, and degree of dehydration. The ORS group had 3.07 stools on average during treatment, significantly more than the 1.58 of the rice water group. The consistency more frequently remained watery in the ORS group. The ORS group gained more weight on average, 0.31 kg vs. 0.20 kg in the rice water group, but the difference was not statistically significant. Serum sodium tended to decline slightly in both groups, with the decline of 1.69 in the ORS group and 0.26 in the rice water group not differing significantly. The results suggest that rice water can be used along with solid foods in the maintenance phase after rehydration with ORS in cases of mild to moderate dehydration, but it should not be used alone as a rehydrating solution. Its use should be evaluated in infants under four months old and in severely malnourished children, who may absorb the carbohydrates too slowly to be effective in reducing fecal losses.