ORS: Saving Countless Lives Worldwide

Oral Rehydration Solution (ORS) is a simple yet powerful treatment that has saved millions worldwide. It is commonly used for moderate dehydration due to diarrhea, vomiting, loose motion, or other complications of our body. It is especially important for treating dehydration caused by diarrhea, a leading cause of death in children under five. The discovery of ORS is the greatest discovery of the 20th century by Dr. Dilip Mahalanabis who was awarded the Padma Vibushan for this invention. His oral rehydration solution became the reason that saved hundreds of lives while voluntarily serving at a refugee camp at  Bangaon in West Bengal.

WHAT IS ORS?

ORS, also known as Electral Powder, is a mix of water, sugar, salt, and electrolytes like potassium and sodium. It helps replace fluids and electrolytes lost due to diarrhea, vomiting, or excessive sweating. WHO and UNICEF recommend ORS as the first treatment for dehydration from acute diarrhea.

COMPOSITION :

The Standard ORS formula consists of:

• Sodium Chloride(salt): It helps restore the salt lost in the body.
• Glucose (Sugar): Sodium and water absorption is facilitated in the intestines.
• Potassium Chloride: Helps replenish potassium lost during dehydration.
• Trisodium citrate: Helps correct acidosis, which can occur during severe dehydration.

This combination is designed to be easily absorbed by the body, ensuring rapid rehydration.

HOW DOES ORS WORK:

Oral Rehydration Solution (ORS) works like a superhero in our body, especially when we are not feeling well due to illness, sickness etc. When we are sick, we lose a lot of water and important minerals from our bodies. This loss makes us feel weak and tired. Oral Rehydration Solution comes to the rescue by providing the mixture of water, salt and little sugar that our body needs. Here it’s work processes:

• It contains glucose and salt, which help increase the absorption of water and electrolytes in the intestine, quickly managing dehydration.
• The solution has a specific ratio of electrolytes to balance osmolarity and osmolality for effective rehydration.
• The small amount of sugar in ORS helps minerals absorb better, aiding faster recovery.
• The gut relies on sodium-glucose cotransporters (SGLTs) in intestinal cells to move substances across membranes.
• SGLTs pair sodium and glucose transport in the small intestine, increasing fluid absorption.
• It includes both glucose and sodium because glucose is crucial for proper sodium absorption.

TYPES OF ORS:

• Low Osmolarity ORS: Reduces diarrhea by 30% and vomiting by 20%, decreasing the need for IV fluids.
• Tri-Sodium Citrate ORS: Treats acidosis and improves sodium and water absorption. It’s long-lasting and recommended by WHO and UNICEF.
• Rice-Based ORS: Especially effective for cholera, reducing stool output by 40% and providing extra glucose.
• Home-based ORS: Ideal for early dehydration signs, preventing further dehydration and maintaining nutritional balance.
• Super ORS: Contains complex sugars and zinc, enhancing rehydration, nutrition, weight gain, stool control, fluid balance, and immunity.

BENEFITS OF ORS:

Oral Rehydration Solution offers several significant benefits. Here are the key benefits:

• Prevents and Treats Dehydration: ORS is highly effective in preventing and treating dehydration caused by diarrhea, cholera, vomiting and other conditions that lead to fluid loss.

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• Cost-effective: It is Inexpensive and accessible, especially crucial in low-resource settings.
• Simple to use: It can be taken at home without a doctor’s help, making it available to many people, even in remote areas.
• Saves lives: It has greatly lowered death rates from dehydration, especially in children.
• Helps digestion: The glucose in ORS helps the body absorb sodium and water, keeping the digestive system healthy and preventing more problems from dehydration.
• Prevent complications: It keeps electrolytes balanced, preventing issues like kidney failure, seizures, and shock.
• Versatile: Works for all ages and is useful in sports, heatstroke, and other dehydration scenarios.
• Widely endorsed: Major health organizations like WHO and UNICEF recommend ORS, proving its effectiveness and safety globally.

USAGE GUIDELINES:

• Dosage: The amount of Oral Rehydration Solution needed depends on the age and severity of dehydration. General guidelines suggest offering small, frequent sips.
• For Children: Typically, 50-100 ml per kg of body weight over the first 4-6 hours.
• For adults: Approximately 3 liters per day, depending on the level of dehydration.
• Monitoring: Watch for signs of overhydration or imbalance, such as bloating, difficulty breathing, or confusion.

WHEN TO SEEK MEDICAL HELP:

While ORS helps with mild to moderate dehydration, severe cases need medical attention. Signs like very dry mouth, rapid heartbeat, no urine, extreme thirst, sunken eyes, and lethargy mean IV fluids and professional care are crucial.

SIDE EFFECTS OF ORS:

ORS is as effective as it prevents dehydration, wrong or excessive use can cause specific side effects such as vomiting, irritability, restlessness, nausea, seizures, unusual weakness, dizziness, and itching or swelling.

If any of these side effects are seen for a long time and worsen the condition, it’s crucial to contact the doctor to avoid severe health complications.

CONCLUSION:

ORS is a vital tool in public health for managing dehydration. Its benefits extend beyond immediate rehydration, contributing to overall health and well-being by preventing serious complications and reducing mortality rates. Its cost-effectiveness, ease of use and proven efficacy make it an indispensable resource in healthcare. By continuing to promote the use of ORS and ensuring its availability, we can save countless lives and improve health outcomes worldwide. As we continue to strive for better healthcare access and outcomes, the story of ORS reminds us that sometimes, the most powerful innovations are those that harness the basics of science to meet the most fundamental human needs.

REFERENCES:

1. Oral Rehydration Salts Therapy Use among Children under Five Years of Age with Diarrhea in Ethiopia – Nasser B. Ebrahim, Madhu S. Atteraya, 2021 (sagepub.com)
2. Medanta | Oral Rehydration Solution (ORS)
3. Oral Rehydration Solution (ORS): https://www.medkart.in/order-medicine/ors-orange-liquid-200ml
4. ORS Newsletter_compressed.pdf (aiimsrajkot.edu.in)
5. A narrative review from clinical practice to main recommendations – PMC (nih.gov)
6. ORAL REHYDRATION SALT (ORS) | PSM Made Easy (ihatepsm.com)
7. Gregorio, G et al, Polymer-based oral rehydration solutions for treating acute watery diarrhea, Cochrane Database of Systematic Reviews, 12, 2016
8. Binder, H et al, Oral Rehydration therapy in the second decade of the twenty-first century, Current Gastroenterology Reports, 16:3, 2014
9. Guerrant, R et al, Cholera, Diarrhea, and Oral Rehydration Therapy: Triumph and Indictment, Clinical Infectious Diseases, 37:3, 398-405, 2003