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Partially Hydrolyzed Guar Gum–Supplemented Oral Rehydration Solution in the Treatment of Acute Diarrhea in Children

Alam, Nur H.; Meier, Remy*; Schneider, Heinz; Sarker, Shafiqul A.; Bardhan, Pradip K.; Mahalanabis, Dilip; Fuchs, George J.; Gyr, Niklaus

Journal of Pediatric Gastroenterology and Nutrition: November 2000 - Volume 31 - Issue 5 - p 503-507
Original Articles

Background Partially hydrolyzed guar gum (Benefiber; Novartis Nutrition, Minneapolis, MN, U.S.A.) is fermented by colonic bacteria liberating short-chain fatty acids (SCFAs), which accelerate colonic absorption of salt and water. The purpose of this study was to evaluate the effect of Benefiber (BF)-supplemented World Health Organization Oral Rehydration Solution (WHO ORS) in the treatment of acute noncholera diarrhea in children.

Methods A double-blind, randomized, controlled clinical trial was performed at ICDDR,B in 150 male children aged 4 to 18 months who had watery diarrhea of less than 48 hours' duration. After admission, children were assigned to receive either WHO ORS or BF-supplemented WHO ORS until recovery. Major outcome measures, such as duration of diarrhea and amount of stool output, were compared between the treatment groups.

Results Patients receiving BF-supplemented WHO ORS had significantly reduced duration of diarrhea compared with the control group (mean ± SD, 74 ± 37 vs. 90 ± 50 hours, P = 0.03). Survival analysis for duration of diarrhea also showed a reduction the BF-supplemented WHO ORS–treated group (P = 0.025, log rank test). There was also less stool output daily from days 2 through 7 in the patients treated with BF-supplemented WHO ORS compared with that in the children treated with WHO ORS; the reduction was significant on day 7 only.

Conclusion Benefiber added to standard WHO ORS substantially reduces the duration of diarrhea and modestly reduced stool output in acute noncholera diarrhea in young children, indicating its potential as a new antidiarrheal therapy for acute diarrhea in children.

Clinical Sciences Division, ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh; *Gastroenterology Unit, Kantonsspital, Liestal, Switzerland; †Novartis Nutrition, Bern, Switzerland; ‡Department of Internal Medicine, University Hospital Basel, Switzerland

Received December 12, 1999; accepted July 10, 2000.

Address correspondence and reprint requests to Dr. Nur H. Alam, Clinical Sciences Division, ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh (e-mail

© 2000 Lippincott Williams & Wilkins, Inc.