EXCLUSIVE: Treating Diarrohea Infection with ORS; How to go about it according to an expert

Diarrhoea is the leading cause of malnutrition and the second-leading cause of mortality in children under five. What makes it all the more tragic is that this is avoidable in most cases. So, what makes diarrhoea fatal to so many children? It causes fluid and electrolyte loss, which can result in severe dehydration. Malnourished children and children with impaired immunity are especially at risk for developing severe diarrhoea and dehydration. Oral rehydration solution, better known as ORS was formulated to avoid such an outcome.

What is diarrhoea?
Diarrhoea is a health disorder where one passes unnaturally loose or liquid stools three times a day or more. It typically occurs due to a viral, parasitic, or bacterial infection in the intestinal tract. It spreads through person-to-person contact or contaminated food or water. It can also be caused due to certain drugs, such as antibiotics, impaired digestive system, or tumours. Clinically, diarrhoea is classified as:
Acute watery diarrhoea, lasting several hours or day – This is also the most common form of diarrhoea witnessed in children
Persistent diarrhoea, lasting 14 days or longer.
Acute bloody diarrhoea, also known as dysentery

One of the severest consequences of diarrhoea is dehydration. It occurs when the loss of water and electrolytes through watery stool, urine, vomit, and sweat during diarrhoea is not replenished. Dehydration can range from mild to severe with the patient showing signs of lethargy, inability to drink, and sunken eyes in severe cases. In extreme cases, it can lead to cardiovascular collapse and death.

In the case of diarrhoea, the emphasis has always been on prevention through improved hygiene and ensuring safe drinking water and food. However, once it is diagnosed, our prime focus is on ensuring that dehydration is avoided. ORS is advocated as the easiest and most cost-effective means of achieving this.

Treating with ORS
ORS can be made at home with clean water, sugar, and salt. However, a more convenient way is to get WHO-approved ORS solutions that are available at any pharmacy. These solutions also contain valuable electrolytes, such as potassium, sodium, and glucose, that are lost along with the water in our body during a diarrheal episode.

The Center for Disease Control & Prevention in the US recommends that ORS should be taken in frequent, but small volumes throughout the day for treating diarrhoea in infants, toddlers, and older children. As per the health agency, ORS is sufficient in treating diarrhoea and dehydration. Lab tests and medication is advised only in case of an outbreak or in special cases such as an impaired immune system, or where an underlying disorder is suspected.

Diarrhoea is especially common among small children since their immune system is still developing and they are still to learn proper hygiene. Hence, parents must always stock ORS solutions at home in order to start treatment as soon as an incidence of diarrhoea occurs.

Getting the right ORS
ORS is commercially available in sachets with a single sachet meant to be dissolved in a specified amount of water. The important aspect to keep in mind when buying ORS is to ensure that it is a WHO-approved solution as it will contain the right proportion of salt and electrolytes. Unfortunately, there are a number of brands that skirt the issue by using similar nomenclature. However, many of these are closer to energy drinks than ORS with unnecessary additives and a high amount of sugar.

Given the easy availability of ORS, there is no reason why diarrhoea still remains the leading cause of mortality in children. It is upon each of us to educate others on the necessity of administering ORS in a timely manner to children and adults who are going through a diarrheal episode. Education and awareness can help save lives.

About the author: Dr Usha Chennuru, Director, Medical Services, Cipla Health Ltd.

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