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Flat coke does the job for kids' diarrhoea, whatever NICE says

NICE has taken the fizz out of its good advice to parents to not run to us about junior's squits by vetoing flat coke or juice as a helpful remedy. Based on what evidence, asks Copperfield.

NICE has taken the fizz out of its good advice to parents to not run to us about junior's squits by vetoing flat coke or juice as a helpful remedy. Based on what evidence, asks Copperfield.

NICE discourages patients from seeing their GP, (pleasant) shock.

It's true – parents worried about junior's squits are being reassured that the symptoms can continue for up to two weeks. And that they're not to worry their pretty little heads – nor mine – for a fortnight, so long as their diarrhoeal progeny are OK in themselves.

That's progress.

Until you get to the other headline grabber from the same guidance. This says that we should stop advising juice flat lemonade and so on for gastroenteritic kids and instead go for oral rehydration salt (ORS).

Hang on. I'm no anecdotalist. But I've been advising those good old homespun remedies for 20-odd years. And I can't remember the last time I admitted a dehydrated toddler.

Where's the evidence these treatments are no good? There isn't any. That's the point. There are no studies looking at the effectiveness of fluids other than ORS in childhood gastroenteritis. But there is research showing that juices et al have a wide variety of electrolyte content.

So, the logic goes, stop using them. And use ORS instead. Bang goes many year's worth of clinical experience and observation.

The result? Parents clogging up the emergency surgery to get a tanker load of Dioralyte free on prescription. Which makes that ‘stay away from the doctor for two weeks' statement about as solid as the patient's stools.

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