By TAP Integrative

Each year in the United States, nearly 180 million episodes of gastroenteritis occur, resulting in almost half a million hospitalizations. When children experience gastroenteritis, treatment is focused on preventing the dehydration that often results from it. This is done by administering an oral rehydration solution aimed at replacing lost electrolytes.

However, electrolyte maintenance solutions can be pricey, and their taste can be off-putting. Caregivers often report difficulty complying with the standard rehydration recommendations. That left a team of researchers wondering whether alternative fluids could have similar results and allow for greater compliance.

In a 2016 study published in JAMA, those researchers outlined the findings of their single-center, randomized, single-blind noninferiority trial. The trial compared the efficacy of 2 different rehydration choices in children with mild gastroenteritis. Patients were randomly assigned to receive either half-strength apple juice diluted with preferred fluids (n=323) or apple-flavored electrolyte maintenance solution (n=324).

The researchers then looked at a number of outcome measures that would indicate treatment failure within 7 days of enrollment, including intravenous rehydration, hospitalization, protracted symptoms, or significant dehydration or weight loss.

The findings? The children in the apple juice group experienced treatment failure less often than those in the electrolyte maintenance solution group (16.7% vs 25.0%). In addition, the apple juice group included fewer children who needed intravenous rehydration (2.5% vs 9.0%). There was no significant difference in hospitalization rates or frequency of diarrhea or vomiting between groups.

This study suggests that for children with mild gastroenteritis and minimal dehydration, starting treatment with apple juice mixed with children’s preferred fluids may be an effective and appropriate alternative to electrolyte maintenance fluids.


Freedman SB, Willan AR, Boutis K, Schuh S. Effect of dilute apple juice and preferred fluids vs electrolyte maintenance solution on treatment failure among children with mild gastroenteritis: a randomized clinical trial. JAMA. 2016;315(18):1966-1774.

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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease