Oral hydration therapy is an alternative approach to prevent nausea and vomiting in patients with COVID-19: A letter to the editor.

Dear editor,

Many patients with COVID-19 have gastrointestinal symptoms such as anorexia, abdominal pain, nausea and vomiting, and diarrhea [1]. Miri et al. Showed that approximately 40% of cases suspected of having COVID-19 had anorexia, 10% had diarrhea, 8% had nonspecific abdominal pain, and 8% had nausea and vomiting [2]. Nausea and vomiting can affect patients ‘appetite and also may cause malnutrition and affect patients’ quality of life and increase their length of hospitalization [3]. A variety of medications are used to control and prevent nausea and vomiting, such as vitamin B6, serotonin receptor antagonists, dexamethasone, neurokinin antagonists, and metoclopramide. Although these treatments have been somewhat effective in controlling vomiting, they can cause side effects such as headache, dizziness, constipation, and insomnia [4]. Moreover, although anti-nausea and vomiting medications can reduce nausea and vomiting in patients with COVID-19, they do not completely eliminate it, so it is recommended to use non-pharmacological methods as a supplement and not as a substitute for drug interventions. To this end, there are complementary medicine methods through which nurses can help patients [5].

Complementary medicine seems to be a safe solution to many health problems that cannot be ignored [6], [7], [8]. Nausea and vomiting can cause dehydration. Dehydration can also reduce the appetite of patients with COVID-19, which in turn worsens the condition of patients. One of the most effective ways to reduce dehydration is to replace fluids orally or intravenously [9], [10]. In Japanese complementary medicine, in oral hydrotherapy, water is used as a medicine at regular intervals, often drunk on an empty stomach, and the water drunk in the gastrointestinal tract stimulates sensitive glands and neurotransmitters. Simultaneously with the muscular stimulation of the esophagus in swallowing, it prepares deep hormonal and nervous effects for the movement of the stomach and related hormones, as well as diluting stomach acid. As a result of the increase in the volume of dilute acid in the stomach, the emptying movements of the pyloric valve become stronger [11]. In oral hydration therapy, two glasses of chilled boiled water (200 cc) in lukewarm form, which stimulates the peristalsis and segmentation movements of the gastrointestinal tract, can be given to fasting patients for 7 consecutive days on an empty stomach. Patients with COVID-19 can start breakfast at least 45 min after drinking water and do not eat anything for up to 2 h after breakfast [12]. In fact this method is related to traditional Japanese medicine. Moreover, in this approach no additives or flavors are added to the water. Due to the fact that the implementation of complementary therapies has rare side effects in patients, in addition, they are simple, in-expensive and safe, and are more acceptable to the patients than pharmacological approaches [6], so it is recommended that studies in the field of oral hydration therapy as an alternative approach to prevent nausea and vomiting be performed on patients with COVID-19 and other patients.

Funding

This letter to editor did not receive any specific grant from fund-ing agencies in the public, commercial, or not-for-profit sectors.

Ethical approval

None. Our paper is in the format of letter to editor.

Consent

None. Our paper is in the format of letter to editor.

Registration of research studies

Not Applicable.

Guarantor

Rasoul Goli.

Provenance and peer review

Not commissioned, externally peer-reviewed.

CRediT authorship contribution statement

Babak Choobianzali: Reviewed the literature and wrote the manuscript.

Sina Shakorzadeh & Rasoul Goli: Supervised the writing process and revised the manuscript.

Declaration of competing interest

None.