The next time you buy oral rehydration solution (ORS) from a chemist’s shop, do not forget to read the label. Do check if the product is made as per the WHO-recommended formula. Due to the extensive marketing of commercially sold energy drinks in the name of ORS for dehydration, people are often led to believe that these products are safe to consume during severe diarrhoea and fatigue. Most people end up choosing the energy drinks advertised widely for dehydration, without reading the labels. These products can worsen the condition. Experts say that it is important to know how to differentiate between ORS and the energy drinks that are sold under its name.
What is oral rehydration solution?
Oral rehydration solution is a sugar and electrolyte solution that plays a vital role in tackling dehydration, diarrhea and restoring electrolyte imbalance that occurs during infections.
The man behind ORS
The simple and effective remedy currently used around the world was first used during the Bangladesh War of Independence when cholera, a diarrhoeal disease that causes severe mortality among infants and young children, broke out at refugee camps in 1971. Indian paediatrician, Dr Dilip Mahalanabis from Kolkata came up with a simple solution and pioneered oral rehydration therapy to treat diarrhoeal diseases, saving millions of lives.
How does ORS work?
ORS, a simple solution containing salt and sugar in the right mixture or proportion, is primarily used to treat dehydration caused due to diarrhoea, says Dr Anantha Krishnan, infectious disease, Prashanth Hospitals, Chennai. “When you have diarrhoea or loose motion, you lose sodium, potassium, chloride and the bicarbonate component from your gut very easily. To replace the lost sodium and glucose, ORS is given,” he says. “ORS is supposed to have 2.6 grams of sodium chloride, 2.9 grams of trisodium citrate dihydrate, 1.5 grams of potassium chloride and 13.5 grams of glucose in one litre of water.” This is the standard composition as per the World Health Organisation.
Dr Krishnan points out that ORS is of two types – normal ORS (powder which is later mixed into water) and reduced osmolarity ORS (liquid form). “Osmolarity is the dissolved solvents in one litre of fluid. It must have an osmolarity of 245 in total with specific values for each ingredient recommended by the WHO. Anything that has more or less [solvents] than the mentioned composition, is not considered ORS.”
Dehydration in children
ORS has been very effective in rehydrating a child with severe diarrhoea, says Dr Paras Kumar J, lead consultant, neonatology and paediatrics, Sparsh Hospital for Women and Children, Bengaluru. “The mainstay of treatment for diarrhoea in children is rehydration, and ORS has been effective,” he says.
He notes that if a child has severe diarrhoea and dehydration, it is vital to bring him/her to the hospital for treatment.
Signs of severe dehydration in children:
- Decreased urine output: The child does not pass urine for more than six to eight hours.
- A drop in energy: The child is very lethargic and irritable.
- Dryness of the oral cavity: The mouth is dry, the eyes are sunken and dry.
What ORS is and what it is not
Dr Krishnan says that several companies are promoting energy drinks in the name of ORS; these are not actually ORS. “Only when a solution is prepared according to the standard set by the WHO, the drink can be considered ORS. Most of the drinks that are available in the name of ORS do not have the right glucose-sodium ratio or the amount of sodium and potassium,” he says.
- As most ORS is tasteless, parents tend to pick up the tetra packs that are labelled ORS. “The energy drinks under the name of ORS have added colours, flavours and preservatives which are not good for children,” says Dr Krishnan, stressing the importance of reading the labels before purchasing.
- Most of these packs that are not recommended by the WHO have a caution statement on them that it is not ORS and should not be consumed during diarrhoea.
- “These drinks could aggravate vomiting in children as they have citric contents. Children will get more dehydrated due to increased vomiting as a result. Hence, it is important to choose the right ORS,” says Dr Kumar.
- Dr Krishnan says that if a person has severe dehydration and is being treated with commercially sold ORS, the sodium and potassium levels in the body could dip and there could arise the need for hospitalisation.
How to make oral rehydration solution at home
Dr Krishnan says that the WHO has also recommended home-based ORS to restore the electrolyte imbalance. One can add six teaspoons of sugar, half a teaspoon of salt in one litre of water to make a home-based ORS.
“ORS should have a specific amount of salt and glucose in one litre of water. One must add only water and not any other solution like milk, tender coconut water, juice or soft drinks. One must not add extra sugar as well. Glucose is to facilitate the absorption of sodium and not just to give energy,” says Dr Krishnan.
Drinking home-based ORS solutions helps in the prevention of dehydration. But it is imperative to consult a doctor if there are signs of severe dehydration.
Oral rehydration solution contains salt and sugar that restore electrolyte imbalance due to severe diarrhoea. It is important to read the labels of commercially sold ORS as not everything that is sold in the name of ORS has the right electrolyte balance.