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Oral Rehydration Therapy - Causes, Signs and Prevention

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Oral rehydration therapy is considered as the standard and first line treatment for dehydration. To learn about oral rehydration therapy read the article below.

Medically reviewed by

Dr. Basuki Nath Bhagat

Published At May 9, 2022
Reviewed AtMarch 7, 2023

Introduction:

Water constitutes about half of our human body, and it is needed for our cell system to function efficiently. When the body loses more amount of fluids than the amount it takes in, then it is a condition called dehydration. Dehydration is one common condition that is seen in cases of diarrhea, cholera and among travelers.

What Is Dehydration?

Dehydration is a condition when a person does not take enough fluids or loses more amount of fluid than he takes in. When your body is deficient in fluids, then the body organs fail to function properly, which can result in some severe complications. Dehydration can be mild or severe. When dehydration is mild, you can get it treated at home only, but when it gets severe, it can even lead to shock or any emergency condition. Usually, your body gets dehydrated when it loses water and when it is not replaced.

What Causes Dehydration?

The common causes of dehydration are not taking sufficient amounts of water or losing more water, or a combination of both factors.

The other causes of dehydration are:

  • Diarrhea.

  • Vomiting.

  • Sweating.

  • Frequent urination.

  • Diabetes.

  • Burns.

These are some of the causes of dehydration.

What Are the Signs of Dehydration?

The signs and symptoms of dehydration are:

Signs of Dehydration

- Lethargy.

- Dry mouth.

- Dry skin.

- Constipation.

- Dizziness.

- Headache.

- Skin pinch reverts slowly.

Along with these signs, there are also some severe signs of dehydration.

They are:

  • Sunken eyes.

  • Rapid breathing.

  • Dark-colored urine.

  • Rapid heart rate.

  • Excessive thirst.

  • Low blood pressure.

  • Inadequate sweat production.

  • Dry and itchy skin.

How to Treat Dehydration?

The treatment for dehydration includes

  • Oral rehydration therapy.

  • Electrolyte replacement.

Oral Rehydration Therapy:

Oral rehydration therapy is giving fluid by mouth in order to treat dehydration. Oral rehydration therapy has substantially reduced the number of deaths from dehydration due to diarrhea or cholera. Cholera can cause dehydration that can even lead to death if left untreated. With timely and proper treatment, more than 99 % of cholera patients can survive. So rehydration therapy is very important.

How to Give Oral Rehydration?

  • Give oral rehydration solutions to the dehydrated patients who are able to sit up and drink.

  • Avoid drinks that have high sugar content because it can worsen the symptoms.

  • Give oral rehydration solutions frequently and measure the quantity of fluids given and the quantity of fluids lost through diarrhea or vomiting.

  • Offer small sips of oral rehydration solutions frequently to dehydrated patients who vomit.

  • Monitor the patient after one hour of the oral rehydration therapy and then check every 1 hour to 2 hours until the rehydration therapy is complete.

How Does Oral Rehydration Therapy Work?

There are various diseases that cause damage to the intestine. In our human body, normally water is absorbed and secreted slowly, and it follows the movement of salts through a process called osmosis. In case of diarrhea, sodium is secreted along with water, and the large intestine is usually secreting rather than absorbing water. So there is loss of water and electrolytes, resulting in dehydration. Hence electrolyte losses also need to be compensated.

Oral rehydration can be achieved by drinking frequent amounts of oral rehydration solutions. It is very important to rehydrate with solutions containing electrolytes, particularly sodium and potassium. Oral rehydration does not prevent diarrhea, rather it keeps the body hydrated until diarrhea stops.

What Is the Composition of Oral Rehydration Solutions?

The typical composition of oral rehydration solution contains a mixture of

  • Water.

  • Glucose.

  • Sodium, potassium, and other electrolytes.

WHO/UNICEF oral rehydration solution contains:

oral rehydration solution

Where to Get the Oral Rehydration Solution?

You can get these oral rehydration solutions from the medical stores in

  • Premixed liquid bottle.

  • Packaged powder forms that need to be mixed with water.

The premixed liquid oral rehydration solutions contain a balanced amount of fluids, salts, and glucose. In the case of powder, if it is not mixed with the specified amount of water, then the resulting oral rehydration solution can be either too concentrated or too diluted, leaving the solution ineffective. Whatever you use, whether you use a premixed bottle or packaged powder, it has to be taken according to the dosage directions given on the package to ensure the maximum effectiveness of the oral rehydration solutions.

How to Give Oral Rehydration Solutions to Children?

  • Oral rehydration solutions should be given in small amounts frequently.

  • Use a spoon or a dropper to give the oral rehydration solutions.

  • Give small amounts of oral rehydration solutions so that the children can retain better amounts of oral rehydration solutions.

  • If in case the children refuse to drink the oral rehydration solution, then try to squirt the solution into the child’s mouth by using a syringe.

  • If still, the child refuses to take the oral rehydration solution, then it has to be given using a nasogastric feeding tube in the hospital. This is usually very rare.

Can Water Be Given to Children if ORS Is Not Available at Home?

Do not just give water, as drinking water alone can result in low salt and sugar levels. You also need to avoid any drinks that are rich in sugar content as it can worsen the symptoms. Do not give any sports drinks or any undiluted drinks.

When Is It Better to Consult a Doctor for Dehydration?

You can seek medical consultation from your doctor if in case your child,

  • Is unusually sleepy.

  • Refuses to drink and continuously has vomiting or diarrhea.

  • Continues to drink but vomits.

  • If the child has not passed urine in the past 12 hours.

Diarrhea is a major cause of death among children. And oral rehydration therapy has proven to fight against diarrhea.

Can Breastfeeding Be Continued In Children on Oral Rehydration Solutions?

Children with dehydration should be continued with breastfeeding along with oral rehydration solutions.

How to Prepare Oral Rehydration Solution at Home?

Homemade oral rehydration solutions are not recommended to treat dehydration. These homemade rehydration solutions can only be used to prevent or delay the onset of dehydration on the way to seeking medical consultation when commercial oral rehydration solutions are not available. It consists of one liter of freshwater mixed with,

  • 1/2 teaspoon of salt.

  • 6 teaspoons of sugar.

Homemade rehydration solutions are usually discouraged as there are serious errors in the formulation. Once prepared, the oral rehydration solutions should be consumed or discarded within 12 hours if it is kept at room temperatures or 24 hours if refrigerated.

What Happens if Dehydration Is Left Untreated?

If dehydration is left untreated, it can even lead to life-threatening complications like:

  • Heatstroke.

  • Seizures due to loss of electrolytes.

  • Heat cramps.

  • Heat exhaustion.

  • Kidney failure.

  • State of coma.

  • Cerebral edema.

  • Low blood volume shock.

How to Prevent Dehydration?

  • If you are not feeling well, make sure you keep yourself hydrated. Take plenty of fluids. If you are not able to intake fluids, then seek medical consultation.

  • If you are going to work out or go for any other sports activities, then try to drink water before the activity and at regular intervals during the workout.

Conclusion:

Oral rehydration therapy is a cheap, easily available, and effective treatment. Rapid rehydration solutions can save many lives. Many patients can be rehydrated completely with the oral rehydration solution itself. It is important to note the early signs of dehydration and to respond quickly. The only point in treating dehydration is to replace fluids and restore the body fluids to normal levels.

Frequently Asked Questions

1.

What Is the Purpose of Oral Rehydration Therapy?

The purpose of oral rehydration therapy (ORS) is to replenish the fluid levels in the body and to treat dehydration caused due to vomiting, diarrhea, or other conditions.

2.

What Are the Types of ORS?

The different types of ORS are as follows:
- Low osmolarity ORS.
- Trisodium citrate ORS.
- Rice-based ORS.
- Home-based ORS.
- Super ORS.

3.

Which Is the Best Oral Rehydration Method?

The best methods of oral rehydration are as follows:
- Oral rehydration salts (ORS) which is a mixture of essential minerals, glucose, and salts.
- Drinking water with electrolytes.

4.

What Is the Recommended ORS Intake per Day?

Every five minutes until urine returns to normal, give the dehydrated individual a sip of ORS or administer the ORS solution. Adults and big kids should consume at least 3 quarters or ORS everyday till they feel better.

5.

Can ORS Be Taken Every Day?

ORS is advised in dehydration and patients with loss of electrolyte. Normally hydrated persons should not take ORS daily as it can lead to the deposition of minerals and extra salts in the body which can lead to arthritis and diabetes.

6.

What Is the Formulation of a Simple ORS?

The World Health Organisation suggests 2.6 grams sodium chloride, 2.9 grams trisodium citrate dihydrate, 1.5 grams potassium chloride, and 13.5 grams anhydrous glucose diluted in 1 Liter of clean water for a total osmolarity of 245 mOsm/L solution.

7.

What Are the Indications of ORS?

The main indications of ORS are as follows:
- Diarrhea.
- Vomiting.
- Burns.
- Sun stroke.
- Excess sun sweating.

8.

Is ORS Better Than Water?

Yes, ORS is better than water as plain water does not contain many electrolytes. ORS contains accurate amounts of electrolytes including sodium and glucose making it the best choice for treating dehydration.

9.

Which Is the Quickest Way to Get Rehydrated?

Drinking water is the quickest and the most ideal way to get rehydrated as water does not contain any forms of added sugars or calories. However, in severe cases of rehydration, ORS may be needed.

10.

What Are the Best Electrolyte-Rich Drinks?

The best electrolyte-rich drinks are as follows:
- Coconut water.
- Milk.
- Watermelon juice and other fruit juices.
- Smoothies.
- Electrolyte-infused waters.
- Electrolyte tablets.
- Sports drinks.

11.

What Is the Composition of ORS?

The composition of ORS is as follows:
- Glucose sodium chloride.
- Potassium chloride.
- Sodium citrate.
- Water.

12.

How Does ORT Work?

ORT works to replenish the body in two ways. They are as follows:
- Glucose or sugar increases the efficiency of salt absorption into the intestine.
- Salts promote the absorption of water into the intestinal walls.

13.

What Are the Side Effects of ORS?

The side effects of ORS are as follows:
- Nausea.
- Weakness.
- Vomiting.
- Loss of appetite.
- Confusion.
- Severe thirst.
- Damage to the kidney.

14.

Is Consumption of ORS Beneficial for Weakness?

When the body is dehydrated it become weak and fatigued. Yes drinking ORS is beneficial for weakness. The body usually feels weak when it is not hydrated. Hence drinking ORS helps a person to feel energetic and active.

15.

What Is the Ratio of Components in ORS?

The ratio of ORS components is as follows:
- One liter or five cups of water, each cup measuring about 200 milliliters.
- Six teaspoons of sugar, one teaspoon measuring about five grams.
- Half a teaspoon of salt.
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Dr. Basuki Nath Bhagat
Dr. Basuki Nath Bhagat

Family Physician

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