is the second leading cause of
death in children under five years old. Poor sanitation and hygiene, are the
major reasons for diarrhea in children. A few episodes of fluid loss and
electrolytes from the body on the form of diarrhea can cause dehydration. In
order to prevent this, ORT, the treatment which involves the administration of
ORS, is necessary. After extensive research, the WHO recommends ORS as the
first step in the treatment of diarrhea-related dehydration.
Originally developed in the
1940's, ORT came into practice in the 1970's. Oral glucose saline solution was
tried on two cholera patients by Captain Philips of the US army. Later, the modern oral rehydration salt
(ORS) solution was developed. Scientists working at the Cholera Research
Laboratory, Dhaka, and the Infectious Diseases Hospital, Calcutta, contributed
to the development and the efficacy of standard ORS which was first
demonstrated during 1965-69.
‘Oral rehydration solution is one of the easiest ways to treat and prevent dehydration. ORS ensures replenishment of fluid and electrolytes in the body.’
researchers in Bangladesh and India found out that adding glucose to water and
salt in the right proportions enabled the liquid to be absorbed through the
intestinal wall. This was an easy method to replace the lost fluids and salts
simply by drinking this solution.
same was tested among Bangladeshi refugees during the Bangladesh liberation war
(1971-72). ORS was also tested in children with diarrhea in the late 1970's.
The WHO in 1978 launched the global diarrheal diseases control program with ORS
as the short-term treatment to reduce the risk of mortality.
ORT is a first line treatment
and is also used to prevent
dehydration. Excessive loss of fluids and electrolytes in the body causes
dehydration. Conditions like vomiting, diarrhea, and diseases which cause
diarrhea such as bacterial or viral infection, cholera, food poisoning,
unhygienic feeding practices can increase the chances of dehydration.
Unless the fluid and electrolyte
loss in the body is replenished, the affected person may even be at risk of
death. Even while fluid is lost through
diarrhea or vomiting, water continues to be absorbed from the gastrointestinal tract. The WHO specifies
indications, preparations and procedures for ORT.
Oral Rehydration Salts
Oral rehydration solution and the oral
rehydration salts used to make it are both often abbreviated as ORS.
The formula for
ORS recommended by WHO and UNICEF contains:
Composition of ORS
(Reference: The management of diarrhoea and use of oral
rehydration therapy a Joint WHO/UNICEF statement.)
The above salts are
dissolved in 1 liter of boiled and cooled water.
- It is a combination of sodium, potassium and citrate
salts mixed in clean water.
- It is suggested by the WHO to be used for the baseline
treatment of diarrhea in infants.
- It should be given when the child has passed three or
more loose stools in a day.
- Zinc is also added along the standard ORS solution. Children over 6 months of
age are given 20 mg of zinc per day (tablet or syrup); 10mg are
recommended for children less than 6 months of age.
every loose stool, 1/4 to 1/2 of a large (250-millilitre) cup of the ORS
should be given to a child under the age of 2 years.
- ORS sachets are commercially available but they can also
be prepared at home. Mix together 6 teaspoons of sugar, half tea spoon of
salt in a liter of clean boiled water.
- History of development of oral rehydration therapy - (https://www.ncbi.nlm.nih.gov/pubmed/7530695
- ORS: The medical advance of the century - (https://www.unicef.org/sowc96/joral.htm)