From the Guidelines
The first line of treatment for diarrhea is oral rehydration therapy (ORT) with oral rehydration solutions (ORS), as recommended by the 2017 Infectious Diseases Society of America (IDSA) guidelines 1. This approach is crucial for replacing lost fluids and electrolytes, and it is applicable to all age groups, regardless of the cause of diarrhea.
- The IDSA guidelines suggest that reduced ORS is recommended as the first-line therapy for mild to moderate dehydration in infants, children, and adults with acute diarrhea from any cause.
- The guidelines also provide specific recommendations for the administration of ORS, including the volume and frequency of administration, depending on the age and weight of the patient.
- For example, infants and children with mild to moderate dehydration should receive ORS, 50–100 mL/kg over 3–4 hours, while adolescents and adults (≥30 kg) should receive ORS, 2–4 L.
- It is essential to note that ORS can be given to all age groups, with any cause of diarrhea, and it is safe in the presence of hypernatremia as well as hyponatremia (except when edema is present) 1. In addition to ORS, other treatments such as anti-diarrheal medications, like loperamide, may be considered for adults with non-bloody diarrhea, but their use should be cautious and based on individual patient assessment 1.
- However, the primary focus should always be on rehydration and replacement of lost electrolytes, as this is the most critical aspect of managing diarrhea and preventing complications such as dehydration.
- If symptoms persist or worsen, or if there are signs of severe dehydration, medical attention should be sought promptly to ensure proper management and prevent potential complications.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
First Line of Treatment for Diarrhea
The first line of treatment for diarrhea involves compensating for water and electrolyte losses through oral or intravenous rehydration 2.
- Oral rehydration solutions are the primary treatment, containing glucose or glucose polymers and sodium, as well as other electrolytes 2, 3, 4.
- Oral rehydration therapy (ORT) is a first-line therapeutic measure to compensate for volume loss due to diarrhea and vomiting among gastroenteritis patients 3.
- The major advance in the management of acute infectious diarrhea has been the development of oral rehydration therapy, which is effective for the treatment of diarrhea of any etiology in patients of any age 4.
- Optimal management of acute infectious diarrhea includes rapid rehydration using an appropriate glucose-based or cereal-based oral rehydration solution, early refeeding with a mixed diet, and no interruption of breast feeding 4.
Oral Rehydration Solutions
Different oral rehydration solutions, such as Pedialyte, Gatorade, and a New Oral Rehydration Solution (N-ORS), have been compared in terms of efficacy, safety, and palatability 5.
- These solutions have been found to be effective in correcting dehydration and improving bowel symptoms, with Gatorade and N-ORS being as effective as Pedialyte 5.
- However, the use of glucose-based oral rehydration solutions has been questioned, as glucose can exacerbate a net secretory state and may aggravate pathogen-induced diarrhea 6.