Discovery of ORS (oral rehydration salt or solution) is one of the greatest discoveries in the field of medical science in recent time. It has saved (still saving and will continue to save) more lives than any other medicine (e.g. penicillin). Discovery of penicillin is considered one of the greatest discoveries of medical science, but simple ORS has saved more lives than penicillin. Every year ORS is saving millions of lives (infants, children and adults alike) around the world, especially in developing countries.

Diarrhea is responsible for mortality, morbidity, social inconvenience, loss of work productivity, and consumption of medical resources of all nations. More than one billion individuals are affected by one or more episodes of diarrhea worldwide every year. It is estimated that globally (mostly in developing countries) approximately 3 million deaths occur due to diarrhea every year, mostly children and infants. But a greater (>3 million) number of deaths are averted by use of ORS in developing countries, which is cheap, easily available and can even be made at home with available ingredients (homemade ORS).

When ORS should be used?

ORS should be used in case of mild to moderate dehydration. If fluid loss due to diarrhea (sometimes due to vomiting also) is 5% to 7% of body weight, it is considered mild dehydration and fluid loss of 7% to 10% of body weight is moderate dehydration. Fluid loss of more than 10% (severe dehydration) needs treatment with intravenous fluid. For example, if body weight of a baby is 10 kilo, loss of 500 ml of body fluid is 5% fluid loss. Ideally correction of dehydration should start from the beginning of diarrhea.

How much ORS should be used for treatment?

The aim of treatment (correction of dehydration) with ORS is to replace the lost body fluid in 2 to 4 hours. For example if a baby has body weight of 10 kilo and has mild dehydration (loss of approximately 5% fluid), the lost fluid i.e. approximately 500 ml (5% of 10 kilo) should be replaced in 2 to 4 hours. In simple words, 500 ml of ORS should be given to the baby in 2 to 4 hours.

Babies should be given ORS every 10-15 minutes with spoon. Thirst due to lost fluid provides adequate driving force for the baby to drink ORS. Once the lost fluid is replaced, it can be left to demand of the baby (patient), but it should cover at least the fluid lost due to diarrhea.

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