Oral rehydration therapy (ORT) involves the replacement of fluids and electrolytes lost during an episode of diarrheal illness. Diarrheal illnesses are pervasive worldwide, and they have a particularly large impact in the developing world. 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. The World Health Organization (WHO) estimates that over one million deaths are prevented annually by ORT. An oral rehydration solution (ORS) is the cornerstone of this treatment. Between 90 and 95 percent of cases of acute, watery diarrhea can be successfully treated with ORT.
Ancient civilizations in India and China made use of sugar and starch solutions to treat dehydration. Oral rehydration solutions make use of the ability of glucose to increase the resorption of fluids and salts into the intestinal wall. The current understanding of ORT was developed in 1968 by researchers responding to a cholera epidemic that began in 1958 in Bangladesh. Intravenous rehydration was inaccessible to much of the population that diarrhea affected, and it was found that oral rehydration solutions could replace such treatment cheaply and effectively. Most importantly, it was easily accessible in the form of prepackaged or homemade solutions.
WHO and UNICEF are the principal sponsors of global rehydration projects. These projects involve the development and distribution of prepackaged solutions, combined with education efforts for instruction in home preparation and delivery. There is some variation among packaged solutions, but the principle ingredients are glucose, sodium, and potassium. The UNICEF recipe for a simple homemade solution contains five cupfuls of boiled water, eight teaspoons of sugar, and one teaspoon of salt, resulting in one liter of solution. Double-sided measuring spoons have also been distributed to standardize measurement. In addition, fruit juices, coconut water, and other indigenous solutions can adequately approximate ORS.
Oral rehydration therapy has increased in use since its development, and it has potential for even greater use. However, severe cases of dehydration continue to need supervised medical care.
Seema Pania Kumar
Agency for International Development (1988). Oral Rehydration Therapy: A Revolution in Child Survival. Weston, MA: Oegeschlager, Gunn & Hain.
Semba, Richard, and Bloem, Martin (2001). Nutrition and Health in Developing Countries. Totowa, NJ: Humana Press.
Rehydration Project. Available from <http://rehydrate.org>