Oral rehydration therapy
Oral rehydration therapy (ORT) is used to treat dehydration caused by diarrhoea. This is important as it is the most dangerous aspect of the illness and ORT helps prevent excessive loss of liquid from the child's body.
Why should I be aware of this?
- As children become dehydrated faster, they are more likely than adults to die from diarrhoea, which is also a major cause of child malnutrition.
- An effective oral rehydration solution can be made using ingredients found in almost every household.
All about oral rehydration therapy
Diarrheal illnesses are pervasive worldwide, particularly in the developing countries. Children under the age of five are the major victims and account for over 3 million deaths a year due to dehydration associated with diarrheal illness. According to the World Health Organization (WHO) estimates, over one million deaths are prevented annually by ORT which can successfully treat between 90 and 95 percent of cases of acute, watery diarrhea.
Two phases of treatment
ORT encompasses two phases of treatment:
- a rehydration phase, in which water and electrolytes are administered as oral rehydration solution (ORS) to replace existing losses,
- a maintenance phase, which includes both replacement of ongoing fluid and electrolyte losses and adequate dietary intake.
Cheap, effective, and acceptable
Oral rehydration therapy is a simple, cheap, effective, and acceptable treatment that can be prepared and administered at home. Conventional treatment by intravenous infusions of glucose and salts is, on the other hand, expensive and should be resorted to in severe cases of dehydration where ORT is not effective.
A mixture--called rehydration salts--of salt, sugar, sodium, potassium (and perhaps other nutrients), and water is fed to the child frequently throughout the day and night. The salt-sugar mix is usually available in packets or tablets to be mixed with clean water. in some places, the bottled mixture may also be available. If the salt-sugar mixture is not available, you can make your own rehydration drink at home.
An ORS packet is dissolved in 1 L of water to produce a solution containing (in mmol/L) Na 90, K 20, Cl 80, citrate 10, and glucose 111 (standard WHO ORS) or Na 75, K 20, Cl 65, citrate 10, and glucose 75 (WHO reduced-osmolarity ORS). It can also be made manually by adding 1 L of water to 3.5 g NaCl, 2.9 g trisodium citrate (or 2.5 g NaHCO3), 1.5 g KCL, and 20 g glucose. ORS is effective in patients with dehydration regardless of age, cause, or type of electrolyte imbalance (hyponatremia, hypernatremia, or isonatremia) as long as their kidneys are functioning adequately. After rehydration, this solution must be replaced by a lower-Na fluid to avoid hypernatremia.
- The influx of 6,000 refugees from the India-Pakistan war in the early 1970s led to the development of the treatment. 
- Children in developing countries can be infected with diarrhoea as often as every four months, and it can kill. 
- Over the last 25 years, an estimated 50 million children's lives have been saved by the therapy. 
- In the 1980s, nearly five million children died each year from diarrhoea. In 2000, that figure had fallen to 1.8 million. 
Sports drinks, sodas, juices, and similar drinks do not serve the purpose and should not be used. They generally have too little Na and too much carbohydrate to take advantage of Na/glucose cotransport, and the osmotic effect of the excess carbohydrate may result in additional fluid loss.