Chiarelli M, De Simone M, Cioffi G, Cioffi U. New paradigm of oral rehydration in patients affected by irritable bowel syndrome with chronic diarrhea. World J Gastrointest Pharmacol Ther 2024; 15(1): 90933 [PMID: 38590832 DOI: 10.4292/wjgpt.v15.i1.90933]
Corresponding Author of This Article
Marco Chiarelli, MD, Researcher, Department of Emergency and Robotic Surgery, A. Manzoni Hospital–ASST Lecco, Lecco via Dell’Eremo 9/11, Lecco 23900, Italy. m.chiarelli@asst-lecco.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pharmacol Ther. Mar 20, 2024; 15(1): 90933 Published online Mar 20, 2024. doi: 10.4292/wjgpt.v15.i1.90933
New paradigm of oral rehydration in patients affected by irritable bowel syndrome with chronic diarrhea
Marco Chiarelli, Matilde De Simone, Gerardo Cioffi, Ugo Cioffi
Marco Chiarelli, Department of Emergency and Robotic Surgery, A. Manzoni Hospital–ASST Lecco, Lecco 23900, Italy
Matilde De Simone, Department of Surgery, University of Milan, Via F. Sforza 35, 20122 Milano, Milano 20122, Italy
Gerardo Cioffi, Department of Sciences and Technologies, Unisannio, Benevento 82100, Italy
Ugo Cioffi, Department of Surgery, University of Milan, Milano 20122, Italy
Author contributions: Chiarelli M, De Simone M, Cioffi G, and Cioffi U contributed equally to the manuscript and all read and accepted the final version.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Chiarelli, MD, Researcher, Department of Emergency and Robotic Surgery, A. Manzoni Hospital–ASST Lecco, Lecco via Dell’Eremo 9/11, Lecco 23900, Italy. m.chiarelli@asst-lecco.it
Received: December 18, 2023 Peer-review started: December 18, 2023 First decision: January 11, 2024 Revised: January 20, 2024 Accepted: February 28, 2024 Article in press: February 28, 2024 Published online: March 20, 2024
Abstract
Irritable bowel syndrome with diarrhea is a very frequent clinical condition characterized by disabling intestinal symptoms. This disease presents with daily abdominal pain for at least 3 months related to defecation and associated with a change in the frequency of bowel movements and the shape of the stool. International surveys about this disease report a global prevalence of about 1.5%. A new amino acid based electrolyte solution has recently been commercialized for oral rehydration in diarrhea. It is composed of water, electrolytes, and five selected amino acids that function as sodium co-transporters without containing glucose. In recent years, some studies explored the effectiveness of the amino acid based electrolyte beverage in oncologic patients with gastrointestinal mucositis, reporting good results. Recently, a prospective study to evaluate the clinical impact of the amino acid based medical beverage was conducted in patients with diarrhea predominant irritable bowel syndrome. The research was based on a real-life methodology minimizing the disruption of the routine care. One hundred patients suffering from irritable bowel syndrome with diarrhea drank a solution based on selected amino acids twice a day for 2 wk. Each enrolled patient completed the study and showed a significant response rate with regard to stool consistency and pain reduction. Based on this data, we can hypothesize that the amino acid based oral rehydration solution could be a valid tool in the treatment of patients affected by irritable bowel syndrome with diarrhea. It is certainly necessary to plan high-quality clinical trials comparing glucose based oral solutions and amino acid based solutions in patients with persisting diarrhea. Probably in the near future all oral rehydration solutions will contain amino acids.
Core Tip: Amino acid based solution has shown promising results in improving symptoms of chemotherapy related diarrhea. Irritable bowel syndrome with diarrhea is a very frequent gastrointestinal disorder. A recent study has been conducted to evaluate the clinical impact of the amino acid based medical beverage on the symptoms of diarrhea predominant irritable bowel syndrome with a real-life methodology. The amino acid based medical beverage seems to be well tolerated and improve gastrointestinal symptoms. The results of this study are very promising and the amino acid based solution will likely become part of the standard treatment for chronic recurrent diarrhea in the near future.
