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Children below five now have much better access to ORS (oral rehydration salts solution) in India than they did at the turn of the century.

India has significantly increased its use of ORS to manage diarrhoea in children under five, from 36.8% in 2000 to 57.8% in 2017, according to an article in the August 2020 issue of The Lancet Global Health (TLGH), an open-access peer-reviewed journal.

This means that more than half the children who get diarrhoeal diseases in the country now receive potentially life-saving fluid therapy in the form of a simple drink.

Diarrhoeal diseases continue to be a leading cause of death among children under five in developing countries, even 50 years after a doctor in Bangladesh discovered that a simple solution of electrolytes, sugar and water—oral rehydration salts solution—can prevent death by dehydration. Indeed, the first trials for the therapy were done right here, in India. That is why every year, 29 July is observed as ORS Day to raise awareness about the life-saving drink.

Read on to know what is ORS, when is ORS needed, benefits of ORS, home-made ORS and the nationwide availability of oral rehydration therapy using ORS or recommended home fluids (RHF) for the management of dehydration in children.

  1. What is ORS?
  2. Uses of ORS
  3. How to make ORS at home
  4. Benefits of ORS
  5. How to give ORS
Doctors for What is ORS solution?

Oral Rehydration Salts (ORS) solution is a mix of water with glucose with three that helps to replenish the electrolytes the body loses during diarrhoea, vomiting and excessive sweating.

The three salts are:

  • Sodium chloride or common salt 
  • Trisodium citrate, dihydrate
  • Potassium chloride

The World Health Organization (WHO) has listed ORS as an essential medicine, to treat acute diarrhoeal diseases in young children. ORS should ideally be given with zinc supplements to young children with diarrhoea, according to the WHO and UNICEF.

ORS is used for rehydrating the body when it has lost a lot of fluids—WHO recommends it especially for the treatment of diarrhoea and vomiting in young children. This is because dehydration and electrolyte loss can disrupt many bodily functions, from the absorption of nutrients to maintaining body temperature.  

Here's how diarrhoea disrupts the normal functioning of our intestines: Our intestines are long tubes. After passing through the stomach, food moves through the intestines where it mixes with enzymes from the livers and pancreas. The intestines absorb the nutrients from food and pass it along to the bloodstream with lots of water. Roughly 20 litres of water goes to and fro, through the intestine walls, in one day. Normally there's a balance to the amount of water that goes in and out of the intestines. This balance, however, is upset when someone has diarrhoea and they lose more water than the body is able to replenish. Research shows that a loss of 10% of fluids from the body can result in death.

Now, as the body loses water, it also loses sodium which is stored in body fluids. The dropping sodium ions disturbs the balance between sodium and potassium in the body, which leads to further problems. The ORS solution helps the intestines absorb sodium from the salt along with the glucose and water and rehydrate the body within a few minutes. Adding sugar is important because consuming salt (for sodium) with water alone could leach more water out of the intestines, worsening the patient's condition.

ORS sachets are widely available, inexpensive and potentially life-saving. If you have one of these sachets, simply mix the ingredients in a litre of water and sip on it slowly.

If you don't have a sachet at home, you can also make a replenishing fluid at home. Here's how:

What you will need: 

  • 30 grams or 6 teaspoons sugar
  • 1/2 teaspoon of salt
  • 1 litre clean water, preferably boiled

How to make it:

  • In a clean bottle add all the ingredients and shake well. Try not to gulp the liquid, but sip on it slowly.

Every year around 1.5 million children die from diarrhoea. Many of these deaths can be prevented, with a simple and inexpensive solution of ORS.

This is especially relevant for developing countries where the lack of clean drinking water and poor hygiene in many areas leads to outbreaks of viral and bacterial infections, which in turn cause diarrhoea and vomiting, leading to severe dehydration and potentially death.

ORS is a simple solution of 20 grams of glucose 3.5 grams of kitchen salt (sodium chloride), 2.9 grams of trisodium citrate dihydrate and 1.5 grams of potassium chloride mixed in a litre of clean (boiled) drinking water.

There are many benefits of ORS:

  • Children with diarrhoea and vomiting may be given ORS solution mixed in clean drinking water to prevent severe dehydration. Parents should start this therapy at the first signs of diarrhoea. Diarrhoea is defined as three loose motions or liquid stools in a day. This is different from the pasty stools that breastfed children pass.
  • ORS starts working within minutes of taking the first sip. The solution rehydrates the body, as the intestines absorb the sodium along with the glucose and water.
  • You don't need a doctor or medical practitioner to administer ORS.
  • It is easily accessible and inexpensive.
  • However, if readymade ORS solution is not available, you can mix sugar and salt in boiled water and give these to the patient. If even these are not available, WHO has shared a list of recommended home fluids (RHF) that may be given. These include lentil soup, cereal gruel and diluted yoghurt drinks.
  • ORS is safe for people of all ages and stages, including for pregnant women.

Taking ORS is fairly simple—that is part of the reason it is highly recommended for the treatment of severe dehydration all over the world. However, a few things should be kept in mind:

  • It's important to sip on the ORS slowly, rather than gulp it down.
  • You should keep sipping on the solution throughout the day, even if you don't feel like it.
  • If you are vomiting and the ORS solution comes back up, don't panic. Try again after 10 minutes. Go slow, but steadily take a sip or two.
  • Adults should drink as much ORS as they can during diarrhoea and vomiting. Young children up to two years of age should be given 60-125 ml of ORS after every watery stool and children over two years of age should be given about 250 ml after each watery stool.
  • Young children with diarrhoea should be given zinc supplements along with ORS.
Dr. Adarsh Bagali

Dr. Adarsh Bagali

Pediatrics
5 Years of Experience

Dr Bishant Kumar

Dr Bishant Kumar

Pediatrics
10 Years of Experience

Dr. Maitreye Datta

Dr. Maitreye Datta

Pediatrics
10 Years of Experience

Dr. Indrajeet L Bahekar

Dr. Indrajeet L Bahekar

Pediatrics
6 Years of Experience

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