Impact of glycine-containing ORS solutions on stool output and duration of diarrhoea: a meta-analysis of seven clinical trials. The International Study Group on Improved ORS.

The results are described of a meta-analysis of seven randomized trials that compared the clinical effects of the standard solution of WHO oral rehydration salts (ORS), containing 20 milligrams of glucose, and experimental ORS solutions, containing glycine, on 643 children with acute noncholera diarrhoea. The availability of data on individual patients in each trial permitted the scope of the meta-analysis to be enhanced because the data could be pooled after adjusting for differences in baseline patient characteristics; also, the statistical strategy in terms of data quality, post-randomization exclusion of patients, and regression modelling could be standardized for all trials. The results of the analysis showed that neither stool output nor duration of diarrhoea was reduced by the experimental formulations. Only for weight gain was there a statistically significant difference between the treatment groups (those given the WHO-ORS solution gained less weight). This probably reflects transient excess fluid retention within the gut lumen or tissues of the patients who received the glycine-containing solutions. ORS formulations that contain glycine are therefore not clinically superior to the WHO-ORS solution.