Efficacy of partially hydrolyzed guar gum (PHGG) supplemented modified oral rehydration solution in the treatment of severely malnourished children with watery diarrhoea: a randomised double-blind controlled trial

Nur Haque Alam, Hasan Ashraf, Mohammad Kamruzzaman, Tahmeed Ahmed, Sufia Islam, Maryam Kadjar Olesen, Niklaus Gyr, Remy Meier, Nur Haque Alam, Hasan Ashraf, Mohammad Kamruzzaman, Tahmeed Ahmed, Sufia Islam, Maryam Kadjar Olesen, Niklaus Gyr, Remy Meier

Abstract

Objectives: To examine whether PHGG added ORS reduce duration of diarrhoea, stool output and enhance weight gain.

Methods: In a double-blind controlled clinical trial, 126 malnourished children (weight for length/weight for age < -3 Z-score with or without pedal edema), aged 6 - 36 months with acute diarrhoea <7 days were studied in two treatment groups; 63 received modified WHO ORS (Na 75, K 40, Cl 87, citrate 7, glucose 90 mmol/L) with PHGG 15 g/L (study group); 63 received modified WHO ORS without PHGG (control). Other treatments were similar in both groups. The study protocol was approved by Ethics Committee of icddr,b; the study was carried out at the Dhaka Hospital.

Results: The mean duration of diarrhoea (h) was significantly shorter in children of the study group (Study vs. control, mean ± SD, 57 ± 31 vs. 75 ± 39, p = 0.01). Although there was a trend in stool weight reduction in children receiving ORS with PHGG (study vs. control, stool weight (g), mean ± SD; 1(st) 24 hour, 854.03 ± 532.15 vs. 949.11 ± 544.33, p = 0.32; 2(nd) 24 hour, 579.84 ± 466.01 vs. 761.26 ± 631.64, p = 0.069; 3(rd) 24 hour, 385.87 ± 454.09 vs. 495.73 ± 487.61, p = 0.196), especially in 2(nd) 24 h period, the difference was not statistically significant. The mean time (day) to attain weight for length 80% of NCHS median without edema was significantly shorter in the study group (study vs. control, mean ± SD, 4.5 ± 2.6 vs. 5.7 ± 2.8, p = 0.027).

Conclusion: PHGG added to ORS substantially reduced duration of diarrhoea. It also enhanced weight gain. Further studies might substantiate to establish its beneficial effect.

Clinical trial registration number: NCT01821586.

Figures

Figure 1
Figure 1
Trial profile.
Figure 2
Figure 2
Kaplan Meier survival curves for duration of diarrhoea.

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