Oral hydration solutions: experimental optimization of water and sodium absorption

Eight solutions of potential efficacy for hydration orally, which differed in composition, osmolality, and pH, were tested in an in vivo perfusion system on rat jejunum to assess the rate of water and sodium absorption or secretion. Optimal results were obtained with a preparation of the type recommended by the World Health Organization, containing 60 mEq/L sodium and 111 mM glucose; there was a maximum influx of both water and sodium, which may be ideal for rehydration. It appeared that the critical factor was the molar relationship between glucose and sodium at a 2:1 ratio. Sodium absorption was inversely correlated with glucose concentration in the perfusates. Osmolality and pH may also have a role in the regulation of fluxes across the mucosa. Citrate at concentrations up to 30 mEq/L did not interfere with water absorption. The data presented may thus contribute to a better rationale for the use of orally administered hydration solutions and guidelines for the preparation of more effective ready-to-use solutions.