A randomized trial using oral rehydration solutions (ORS) with rice or glucose was carried out in 342 patients with acute watery diarrhoea. On admission, 75% of these patients had severe dehydration and 70% werepositivefor Vibrio cholerae. There were 185 children aged under 10 years and 157 adults; 169 patients were treated with rice-ORS and 173 with glucose-ORS. Patients in both groups were comparable in age and body weight, as well as the duration and severity of illness. Patients with severe dehydration were first rehydrated intravenously, and then treated with ORS. Those with moderate dehydration received ORSfrom the beginning. The mean stool output in thefirst 24 hours in children treated with rice-ORS was less than that in those treated with glucose-ORS (155 vs 204 ml/kg/24 h; P< 0.01). The same was truefor the adult patients, the corresponding values for stool output being 115 vs 159 ml/kg/24h (P< 0.05). The mean ORS intake in children was263. 5 vs379. 6 ml/kg/24 h, respectively, for rice-ORS and glucose-ORS (P< 0.05); the corresponding intakes in adult patients were, respectively, 180.5 and 247 ml/kg/24 h. A gain ofabout 10% ofthe body weight on admission was observed in all the groups. Six cases (4 children and 2 adults), who failed to respond to oral rehydration after intravenous therapy, all belonged to the glucose-ORS group.

Oral rehydration therapy is simple and inexpensive, but can be improved further to reduce the cost and provide increased nutrition (1, 2). Thus, less expensive sucrose has been used instead of glucose (3, 4); polymers of glucose (5) and individual amino acids (6) have also been used, and chicken soup with glucose or starch has been suggested (7). Although a sucrose-electrolyte solution is as effective as the glucose-electrolyte solution in treating acute diarrhoea, the osmotic penalty from the presence of these small molecules in the gut lumen imposes a limit to the number of calories that can be given in such solutions. Recently 30 g of rice powder with the recommended electrolytes has been used successfully in oral rehydration solutions (ORS) to treat acute diarrhoea (8). In vivo the hydrolysis of rice by intraluminal enzymes gradually yields glucose, amino acids and oligopeptides, which enhance sodium absorption through an independent carrier system (9). A study in Calcutta using 50 g of rice powder per litre of ORS not only effectively hydrated patients