Fluids and Electrolytes

Diarrhea is usually the most distressing problem for patients with malabsorption and may cause dehydration. Care should be taken to correct fluid losses with appropriately designed oral rehydration solutions. Even in the setting of massive secretory diarrhea, such as seen with cholera infections, oral rehydration solutions are effective at treating dehydration. Data support the safety and efficacy of oral rehydration solutions of reduced osmolarity in children with dehydration from acute diarrhea. An oral rehydration solution composed of glucose 75 mmol/ L, sodium 75mmol/L, potassium 20mmol/L, base 30mEq/L, and osmolality 245mOsm/L is well suited for the rehydration and maintenance therapy during dehydration due to diarrhea.

In some cases of severe diarrhea, parenteral hydration is the mainstay of therapy. Examples include glucose-galactose malabsorption, congenital chloride diarrhea, microvillous inclusion disease, and tufting enteropathy. These cases, as well as other severe causes of more common malabsorptive syndromes, also frequently require the use of par-enteral nutrition therapy.

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