What is ORS?
Oral Rehydration Salt is a mixture of electrolytes and sugar specially prepared to help correct any form of electrolyte imbalances in individuals who have lost fluids from having diarrhoea.
People can lose fluids and for that matter electrolytes that are very important to the body. An imbalance of electrolytes in the body can result in a number of disorders. If care is not taken, such an imbalance can even lead to death.
The loss of fluids or electrolytes could be through:
- Excessive sweating
- Renal impairment (kidney failure)
In managing any of these conditions, the ideal thing to do is to assess the individual’s hydration status and perform laboratory investigations on the electrolytes. For people who are mildly to moderately dehydrated, the fluid and electrolyte replacements can be achieved by giving ORS.
ORS is meant to be given orally, that is to say it must be taken by mouth and not injection. In severe cases of the dehydration, a more intensive regimen will be required for fluids and electrolyte replacement.
What are the components of ORS?
ORS is made up of a combination of salt and sugar in a predetermined ratio put into a clean volume of water.
However the commercially available oral rehydration salt contains more than just the sugar and the table salt.
The commercial ORS contain a mixture of:
- Potassium chloride
- Sodium Chloride
- Sodium Citrate
These ingredients are pre packed into a sachet which can easily be opened and the content poured into a certain volume of clean water.
What is the role of each of the components in ORS?
Each component of ORS whether home-made or commercially available plays a key role in the body.
Almost any one who will require ORS is likely to have severe diarrhoea meaning they are passing everything they eat including the water they take out of the body.
Most of the electrolytes are water soluble and dissolve in the water that is lost. Hence, inevitably such electrolytes too are lost.
To replenish the energy of the individual suffering such fate, glucose (a simple sugar) is added to the ORS. This will provide one essential nutrient that the body requires for the various life processes.
Sodium, Potassium and Chloride are very important minerals that the body needs to regulate various processes. An imbalance in their concentration in the body can therefore be fatal.
For example, potassium is required by the heart muscles in the process of contraction. A lower potassium concentration can result in heart issues (eg: arrhythmias) which can be very fatal.
Therefore the other components of ORS like the salts or sodium chloride, potassium chloride or sodium citrate are supposed to replenish the quantities of these important minerals in the body.
Just as lower concentrations can be lethal to the body, higher concentrations can equally be fatal. As such, the amount given should be supported with evidence. If possible do so with the help of laboratory investigation results.
Water will help to replenish the fluids lost from the body and restore the hydration status to satisfactory.
How is a home-made ORS prepared?
As mentioned earlier, home-made ORS is basically made up of sugar and salt. To prepare your own ORS at home, follow the following steps.
- Wash your hands thoroughly:
This is very important and you have to ensure that you do it effectively. It is recommended that you wash your hands with soap under running water. This is because most causes of diarrhoea are from fecal-oral route.
- Collect the things you need
You need to have your sugar, salt, clean water and washed utensils (container and spoon) that you are going to use for preparing the ORS.
- Mix the components in their right proportion:
For home-based ORS, you will need to add half level teaspoon of table salt to six level teaspoons (or two tablespoons) of sugar in a clean container (preferably a cup).
- Add clean water to the mixture
Add one litre of clean water (freshly boiled and cooled, or filtered water), To get one litre, you can just make use of two sachets of filtered drinking water (about 500ml each).
- Stir well and drink
Use a spoon or whisk to stir the mixture. After a minute or two of vigorous stirring, the solution formed is now ready to drink.
Note that for each one litre of water, the amount of salt and sugar is what has been described above. You can therefore scale the formula up for larger volumes or scale it down for lesser volumes.
For instance, if you want to prepare about 4 litres of home-made ORS, then you will require 2 level teaspoons of salt and 24 level teaspoons (or 8 tablespoons) of sugar. Adding excess sugar can worsen the diarrhoea, and adding excess salt can harm the individual hence it is required to use the recommended amounts stated all the time.
Can you make ORS with other fluids aside water (like fruit juice, milk etc)
For the preparation of the oral rehydration salt solution, other liquids are not recommended as solvents for the salt and sugar. However, since individuals who require ORS are likely to be in need of fluids and some electrolytes, it is recommended to encourage such individuals to take in other fluids other than ORS solution.
For instance, coconut water, orange juice, mashed ripe bananas and rice water porridge are recommended since these can help replenish the water as well as some of the electrolytes.
What happens when I am not able to drink all the prepared volume of ORS?
It is advised that you take the prepared ORS slowly and frequently in order to put the proper amount of fluid back in a timely manner. The idea behind sipping the ORS solution slowly and frequently is to have about 80 to 100 mL of the solution in the body every 15 minutes. However, you can have it with you and use it throughout the day (24 hours).
If you are unable to finish drinking the volume of the ORS that you prepared then, you have to discard the rest. The advice is that don’t keep a home-made ORS for more than 24 hours.
The basic reason for this recommendation is that a solution containing a higher concentration of sugar is a very good medium for the growth of bacteria. If you are not careful, you will be taking a culture of bacteria if you sip it after about 24 hours of preparation.