Intestinal absorption during rest and exercise: implications for formulating an oral rehydration solution (ORS). Proceedings of a roundtable discussion. April 21-22, 1993.

Formulation of oral rehydration solutions (ORS) is reviewed in the context of methods for measuring absorption of water and component substrates, transport mechanisms of substrates and water, requirements of the athlete, and effects of exercise on absorption. The triple lumen tube intubation perfusion method is the optimal technique for obtaining absorption data from the human small intestine during rest and exercise. Factors that must be considered when interpreting absorption data obtained by this technique include the role of the mixing segment in altering composition of the infused solution, defining optimal segment length, effects of ORS osmolality, and absorption of "nonabsorbed" indicators. Absorption data are applicable only to the test segment and may lack relevance to ORS transport proximal and distal to the test segment. Absorption rate of an ORS measured by perfusion may not correlate with absorption rate following ingestion. Transport of water, electrolytes, carbohydrates, and other solutes including glutamine and amino acids is considered in relation to ORS formulation. Factors affecting absorption of an ORS including the unstirred layer, motility, intestinal blood flow, and maximal absorptive capacity of the alimentary tract are considered. Exercise per se at 30-70% VO2max for 60-90 min probably has minimal effects in limiting absorption of an ORS. Consideration relevant to supplying needs of the athlete during prolonged exercise in relation for ORS formulation are discussed.