điều này thường xuyên có thể được thực hiện bằng cách sử dụng các dung dịch bù nước uống (ORSs). Một số bệnh nhân bị tiêu chảy nặng có thể có chức năng giữ lại bình thường hấp thụ, và uống bù nước hoặc thay thế có thể có hiệu quả trong họ. | 426 Advanced Therapy in Gastroenterology and Liver Disease this can frequently be accomplished using oral rehydration solutions ORSs . Some patients with severe diarrhea may have normal absorptive function retained and oral rehydration or replacement can be effective in them. Because nutrient absorption is coupled with sodium absorption glucose or amino acids in combination with sodium can enhance the absorption of electrolytes and water. It is important to remember that standard ORSs are primarily designed to increase electrolyte and fluid absorption and may not reduce stool output and in fact stool output may increase. The World Health Organization s WHO ORS recommendation contains sodium 90 mmol L potassium 20 mmol L chloride 80 mmol L citrate 30 mmol L and glucose 111 mmol L . This is prepared by adding g of sodium chloride g of potassium chloride g of trisodium citrate dihydrate and 20 g of glucose per liter of water. Rice-based ORSs have been shown to not only increase absorption but also to decrease stool volume. Most sport drinks such as Gatorade are designed to replenish electrolytes primarily lost from sweat and do not have enough sodium to fully replace diarrheal sodium loss. Commercial solutions available that approximate the WHO s ORS include Resol Ricalyte Ceralyte Pedialyte and Rehydralyte. Intravenous Replacement In patients with severe diarrhea such as frequently occurs with vIPomas with the need to adequately correct the dehydration hypokalemia and metabolic alkalosis the fluid and electrolyte replacement needs to be given intravenously. This can be accomplished by using parenteral hyperalimentation or administration of saline solutions supplemented with potassium and sodium bicarbonate. Restoration of hydration and electrolytes can best be monitored by serial assessment of serum electrolytes and urine output. Pharmacologic Control of SD A number of different agents are used to control acute and long-term chronic diarrhea. As pointed .
