Case: A 28-month-old boy presents with a three-day history of vomiting and diarrhea. After performing an appropriate history and directed physical examination, you diagnose him with mild gastroenteritis and minimal dehydration. The parents ask if they need to buy an electrolyte maintenance solution or if they could just use some watered-down apple juice to treat his dehydration.
Clinical Question: In children diagnosed with mild gastroenteritis who have minimal dehydration, is dilute apple juice followed by preferred fluids an equivalent way to orally rehydrate compared to an electrolyte maintenance solution?
Background: Acute gastroenteritis is a common childhood illness in the United States. It’s characterized by acute-onset diarrhea with or without nausea, vomiting, fever, and abdominal pain. According to King et al, acute diarrhea results in more than 1.5 million outpatient visits and 200,000 hospitalizations per year.