One hundred twenty-eight 128 otherwise healthy children (aged 6-24 months; mean, 12.6 months) with acute diarrhea were randomly assigned to receive, in double-blind fashion, oral glutamine (0.3 g per kg of body weight per day) or placebo for 7 days, in addition to standard therapy. The mean duration of diarrhea was significantly shorter in the glutamine group than in the placebo group (3.40 vs. 4.57 days; 25.7% reduction; p = 0.004). Compared with placebo, glutamine had no effect on serum interleukin-8 and salivary IgA levels, suggesting that its effects on the gastrointestinal mucosa, rather than on immune function, were responsible for the improvement in diarrhea.

Comment: Glutamine is known to protect the structure and function of the intestinal mucosa in various catabolic states. The present study demonstrates that glutamine supplementation can decrease the duration of acute diarrhea in children. While the dose used was relatively large (equivalent to 21 g/day for a 70-kg person), even larger doses of glutamine have been given to humans without producing any apparent deleterious effects. Glutamine should, therefore, be considered for the treatment of young children with acute diarrhea.

Yalcin SS, et al. Effect of glutamine supplementation on diarrhea, interleukin-8 and secretory immunoglobulin A in children with acute diarrhea. J Pediatr Gastroenterol Nutr 2004;38:494-501.