Efficacy of the <i>Cordia myxa</i> Syrup (Sepestan) on Reduction of Severity and Duration of Diarrhea in Pediatrics with Gastroenteritis: A Randomized Placebo-Controlled Trial

Abstract

Background: Diarrhea is one of the most common gastrointestinal problems in children, potentially leading to dehydration, weakness, and hospitalization. Various treatments have been proposed to reduce the severity and duration of diarrhea; however, the need for more effective approaches remains. Objectives: This study aimed to evaluate the efficacy of Cordia myxa syrup, known as “Sepestan,” in reducing the severity and duration of diarrhea in patients with gastroenteritis. Methods: This double-blinded, randomized controlled clinical trial was conducted using the simple randomization method. A total of 140 patients with gastroenteritis aged 1 - 8 years, referred to Abuzar Hospital in Ahvaz, Iran in 2024, were enrolled. Patients with gastroenteritis whose symptoms had occurred within less than 24 hours, with no prior medication use, no severe dehydration, and no abnormal stool findings were included. These eligible patients were divided into two equal groups: The intervention group (receiving C. myxa syrup) at a dose of 20 mg/kg/day, and the control group (receiving placebo). Data on age, sex, diarrhea severity and frequency, stool volume and consistency, duration of diarrhea, and other clinical symptoms were recorded and analyzed on days 1, 2, 3, and 7. Both the patients (and their parents) and the researchers were blinded to the assigned treatment groups. Results: The mean age of participants was 27.53 ± 18.81 months. The C. myxa group demonstrated a statistically significant reduction in diarrhea duration (mean 3.91 days vs. 4.71 days in the control group, P = 0.000) and diarrhea frequency at 72 hours (P = 0.023). Stool volume analysis indicated a remarkable treatment effect (F = 49.929, P < 0.001), and stool consistency analysis also showed considerable improvement in the intervention group (F = 39.803, P < 0.001). Age had no significant effect in any statistical model, such as stool volume (P = 0.892) or stool consistency (P = 0.961). Conclusions: Our findings suggest that C. myxa syrup can significantly reduce both the duration and severity of diarrhea. This syrup may serve as an effective therapeutic option for patients with gastroenteritis. Limitations of this study were the single-center nature of the study, the short follow-up period, and restriction to a specific age group. Further multicenter studies with longer follow-up periods are recommended to confirm its effectiveness.