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Oral Rehydration Therapy

"The discovery that sodium transport and glucose transport are coupled in the small intestine so that glucose accelerates absorption of solute and water (is) potentially the most important medical advance this century."

British Scientific Journal - 5th August, 1978

Sushruta, an ancient Indian medical scholar and the father of Ayurveda (1500 B.C.) had prescribed that cholera victims are to be: "given to drink a profuse quantity of tepid water in which rock salt and molasses have been dissolved; or clarified water combined with rice gruel." Sushruta Samhita III, verse II

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What to do if Dehydration Occurs

How Oral Rehydration Therapy Works
Saves 1 million a year
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ORT Achievements and Challenges
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First Do No Harm:
Making Oral Rehydration Solution (ORS) Safer In A Cholera Epidemic

Facts for Life Diarrhoea
ORS Solution: A special drink for diarrhoea

Diarrhoea usually cures itself in three to four days with rehydration (drinking a lot of liquids). The real danger is the loss of liquid and nutrients from the child's body, which can cause dehydration and malnutrition.

A child with diarrhoea should never be given any tablets, antibiotics or other medicines unless prescribed by a trained health worker.

The best treatment for diarrhoea is to (1) drink lots of liquids and oral rehydration salts (ORS), properly mixed with clean water from a safe source, and (2) take zinc tablets or syrup for 10–14 days.

ORS Solution
A special drink for diarrhoea
What is ORS? ORS (oral rehydration salts) is a special combination of dry salts that is mixed with safe water. It can help replace the fluids lost due to diarrhoea.
When should ORS be used? When a child has three or more loose stools in a day, begin to give ORS. In addition, for 10–14 days, give children over 6 months of age 20 milligrams of zinc per day (tablet or syrup); give children under 6 months of age 10 milligrams per day (tablet or syrup).
Where can ORS be obtained? In most countries, ORS packets are available from health centres, pharmacies, markets and shops.
How is the ORS drink prepared?
  1. Put the contents of the ORS packet in a clean container. Check the packet for directions and add the correct amount of clean water. Too little water could make the diarrhoea worse.
  2. Add water only. Do not add ORS to milk, soup, fruit juice or soft drinks. Do not add sugar.
  3. Stir well, and feed it to the child from a clean cup. Do not use a bottle.
How much ORS drink to give? Encourage the child to drink as much as possible.

A child under the age of 2 years needs at least 1/4 to 1/2 of a large (250-millilitre) cup of the ORS drink after each watery stool.

A child aged 2 years or older needs at least 1/2 to 1 whole large (250-millilitre) cup of the ORS drink after each watery stool.

What if ORS is not available? Give the child a drink made with 6 level teaspoons of sugar and 1/2 level teaspoon of salt dissolved in 1 litre of clean water.

Be very careful to mix the correct amounts. Too much sugar can make the diarrhoea worse. Too much salt can be extremely harmful to the child.

Making the mixture a little too diluted (with more than 1 litre of clean water) is not harmful.

Diarrhoea usually stops in three or four days.

If it does not stop, consult a trained health worker.

Download and Print Instructions: Home made Oral Rehydration Salts (ORS) for treating dehydration caused by diarrhoea Download pdf

10 Things you should know about Rehydrating a child.

  1. Wash your hands with soap and water before preparing solution.
  2. Prepare a solution, in a clean pot, by mixing - Half (1/2) teaspoon Salt and Six (6) teaspoons sugar
    - 1 packet of Oral Rehydration Salts (ORS)
    - with one litre of clean drinking or boiled water (after cooled) Stir the mixture till all the contents dissolve.
  3. Wash your hands and the baby's hands with soap and water before feeding solution.
  4. Give the sick child as much of the solution as it needs, in small amounts frequently.
  5. Give child alternately other fluids - such as breast milk and juices.
  6. Continue to give solids if child is four months or older.
  7. If the child still needs ORS after 24 hours, make a fresh solution.
  8. ORS does not stop diarrhoea. It prevents the body from drying up. The diarrhoea will stop by itself.
  9. If child vomits, wait ten minutes and give it ORS again. Usually vomiting will stop.
  10. If diarrhoea increases and /or vomiting persists, take child over to a health clinic.


from Wikipedia, the free encyclopedia

Rehydration is the replenishment of water and electrolytes lost through dehydration. It can be performed by mouth (oral rehydration) or by adding fluid and electrolytes directly into the blood stream (intravenous rehydration).

As oral rehydration is less painful, less invasive, less expensive, and easier to provide, it is the treatment of choice for mild dehydration from infectious gastroenteritis. Because severe dehydration can rapidly cause permanent injury or even death, intravenous rehydration is the initial treatment of choice for that condition.

Symptoms of dehydration

Symptoms of mild dehydration includethirst, decreased urine volume, urine that is darker than usual, tiredness, lack oftears whencrying,headache, dry mouth, anddizziness when standing due to orthostatic hypotension.

In moderate to severe dehydration, there may be no urine output at all. Other symptoms in these states includelethargy or extreme sleepiness,seizures, sunken fontanel (soft spot) ininfants,fainting, and sunken eyes.


If someone is sufficiently dehydrated that he or she exhibits the signs of moderate to severe dehydration listed above, medical attention should be sought.

Oral rehydration can be accomplished by drinking frequent small amounts of an oral rehydration salt solution. One standard remedy is the WHO/UNICEF glucose-based Oral Rehydration Salts (ORS) solution, which contains 75 mEq/l of sodium, 75 mmol/l of glucose, 65 mEq/l chloride, 20 mEq/l potassium, and 10 mEq/l citrate, with a total osmolarity of 245 mOsm/l.

It is important to rehydrate with solutions that contain electrolytes, especially sodium and potassium, so that electrolyte disturbances may be avoided. Sugar is important to improve absorption of electrolytes and water, but if too much is present in ORS solutions, diarrhea can be worsened. Oral rehydration does not stop diarrhea, but keeps the body hydrated and healthy until the diarrhea passes.

There are several commercially available products but an inexpensive home-made solution consists of 8 level teaspoons of sugar and 1 level teaspoon of table salt mixed in 1= liter of water. A half cup of orange juice or half of a mashedbanana can be added to each liter both to add potassium and to improve taste. If commercial solutions are used, true rehydration solutions should be used and sports drinks should be avoided (especially in younger children) as these solutions contain too much sugar and not enough electrolytes.

The amount of rehydration that is needed depends on the size of the individual and the degree of dehydration. Rehydration is generally adequate when the person no longer feels thirsty and has a normal urine output. A rough guide to the amount of ORS solution needed in the first 4-6 hours of treatment for a mildly dehydrated person is:

  • Up to 5 kg (11 lb): 200 – 400 ml
  • 5-10 kg (11-22 lb): 400 – 600 ml
  • 10-15 kg (22-33 lb): 600 – 800 ml
  • 15-20 kg (33–44 lb): 800 – 1000 ml
  • 20-30 kg (44-66 lb: 1000 – 1500 ml
  • 30-40 kg (66-88 lb): 1500 – 2000 ml
  • 40 plus kg (88 lb): 2000-4000 ml


Adults and children with dehydration who are not vomiting can be allowed to drink these solutions in addition to their normal diet. People who are vomiting should be fed small frequent amounts of ORS solution until dehydration is resolved. Once they are rehydrated, they may resume eating normal foods when nausea passes.

Vomiting itself does not mean that oral rehydration cannot be given. As long as more fluid enters than exits, rehydration will be accomplished. It is only when the volume of fluid and electrolyte loss in vomit and stool exceeds what is taken in that dehydration will continue. When vomiting occurs, rest the stomach for ten minutes and then offer small amounts of ORS solution. Start with a teaspoonful every five minutes in children and a tablespoonful every five minutes in older children and adults. If output exceeds intake or signs of moderate to severe dehydration occur, medical assistance should be sought.

updated: 10 November, 2014