Abstract
BACKGROUND: Patients with short bowel syndrome (SBS) have a loss of absorptive bowel surface area and are at risk for dehydration. Oral rehydration solutions (ORS) promote intestinal fluid absorption and may be used to maintain adequate hydration. Currently, there are no standard ORS recommendations for children with SBS. The objectives of this study are to (1) characterize the ORS practice patterns of pediatric intestinal rehabilitation providers and (2) understand the perceived barriers to patient compliance. METHODS: A survey was created with questions regarding provider details, current practice recommendations for ORS, and the factors affecting ORS compliance. The survey was distributed electronically to intestinal rehabilitation providers in North America. RESULTS: 66 individuals with varying clinical roles from across North America completed the survey. Most respondents recommend Pedialyte® (60/66) and the second most commonly recommended ORS is the homemade World Health Organization (WHO) ORS recipe (31/66). Regardless of the type of ORS, the most common reasons identified for poor patient compliance are poor taste and cost, with taste being a greater issue for the homemade solutions and cost being a greater issue for the commercially available products. Insurance coverage for ORS is limited (only reported for Pedialyte® and Ceralyte®). DISCUSSION: The recommended ORS products contain variable sodium concentrations and variable sugar sources. The effect of these alternative sugar sources on intestinal absorption in SBS is not yet fully understood. Improved insurance coverage for ORS should be considered as this is cited as a barrier to the use of ORS in pediatric SBS.