The effects of diarrhea can be devastating, leading to severe dehydration and, in some cases, death. But, thanks to Yale and Bill Gates, help may be on the way.
The Bill & Melinda Gates Foundation recently offered $1.8 million to the Yale School of Medicine to help fund clinical trials for a modified treatment of dehydration caused by diarrhea. After 15 years of research, Yale School of Medicine Professor Emeritus of Medicine Henry J. Binder, along with Dr. B. S. Ramakrishna, professor of gastroenterology at Christian Medical College in India and Professor Graeme P. Young, head of the Flinders Centre for Cancer Prevention and Control at Flinders University in Australia, has proposed that a modification of the oral rehydration solution (ORS) be used to treat diarrhea.
This medical breakthrough began as an accident, Binder said.
“Our initial laboratory experiments were not designed to address the issue of ORS,” he said. “But through our observations, we devised a strategy that could improve the treatment in a very positive manner.”
“Some people have said that our findings are one of the greatest therapeutic advances over the last century,” he added.
Binder’s research began in 1999, when he conducted research trials in southern India to treat cholera. Cholera releases a toxin in the digestive system that causes the human body to produce massive amounts of watery diarrhea, causing dehydration and possibly death.
ORS is a therapeutic method discovered over 35 years ago that mends chemical imbalances in the body. ORS consists of glucose electrolytes that enhance and stimulate fluid absorption in the body, thus reducing the result of diarrhea.
Through his research, Binder was able to uncover a modification in the ORS system — by adding starch he found that it provided a way to deliver short chain fatty acids to the colon, which augmented fluid absorption, decreasing the likelihood of a fatality from dehydration. The modified version of ORS would not require intravenous solutions, which tend to be too expensive for patients in developing nations.
School of Medicine Chief of Digestive Diseases Michael Nathanson praised the proposed modification in the wake of cholera.
“Given that digestive disorders which collectively cause diarrhea are the second leading cause of death in children under age 5 worldwide, the potential benefits of this new oral rehydration solution are quite significant,” he said.
But there may be problems when implementing the modified treatment on a large scale. The new formula may not be well-received in developing countries, Binder said, due to misconceptions about the digestive disease and treatments.
“The problem has been that mothers and caregivers don’t want to use ORS because they don’t appreciate its effectiveness,” he said. “Because they don’t understand the process and they aren’t seeing a dramatic immediate decrease in the diarrhea, they don’t think it works and thus don’t want to use it.”
In order for the modification to become a recommended formulation, it would need to be tested globally in different populations, Binder said.
Still, Binder’s colleagues see promise in his work.
“[Binder’s] research indicates that once it has been tested in large numbers, it will definitely be helpful in the field of medicine and for the global community as well,” Professor of Clinical Medicine Martin Floch said.
The researchers are currently working on a proposal that they will submit to the Gates Foundation within 18 months. If approved, the researchers will move forward in conducting clinical trials of the modified version of the solution.
Correction: Aug. 18, 2012
This article originally misstated the titles of Professor Emeritus of Medicine Henry J. Binder and Professor of Clinical Medicine Martin Floch.