What Discharge Instructions Should I Give? Oral Rehydration, Zinc Supplementation, Diet, Probiotics, and Antimotility Medications

Abstract

For mild to moderate dehydration, oral rehydration therapy (ORT) delivers replacement of fluids and electrolytes in a safe, cost-effective manner. In a meta-analysis of 16 studies of 1545 children in 11 countries, oral rehydration was associated with fewer major adverse events (relative risk 0.36, 95% confidence interval, 0.14-0.89) and shorter hospital stays (mean 21 h; 95% CI, 8-35 h) compared to IV hydration. In the United States, oral rehydration solutions include Pedialyte, Infalyte, or WHO oral rehydration solutions. In 2004, WHO and United Nation’s Children fund (UNICEF) recommended zinc supplementation for acute diarrhea in children <5 years of age. Patients should no longer be limited to bananas, rice, applesauce, and toast as has been promoted in the past, but instead a healthy diet should be encouraged to promote enterocyte recovery.