Oral Rehydration Solution (ORS)
Oral rehydration therapy (ORT) treats dehydration caused by severe diarrhea through the replacement of lost fluids.
Elements of ORT include oral rehydration solution (ORS), breast milk, soups, cereals, and rice water mixed with salt.
ORS is the cornerstone of diarrhea treatment in low-resource settings.
One liter of water, six teaspoons of sugar, and a half teaspoon of salt (find the full recipe here): this simple mixture has saved millions of lives and costs just pennies. Easy to prepare and administer in the home, ORS empowers parents with the first line of treatment for children suffering from diarrhea. In a review of 157 studies, ORS reduced deaths from diarrhea by 69%. 1
An improved ORS formula with lower sodium and glucose makes it more efficacious than ever. This low-osmolarity ORS lowers stool output, reduces vomiting, and minimizes the need for expensive emergency IV therapy. The World Health Organization (WHO) and UNICEF recommend low-osmolarity ORS and zinc as essential to clinical treatment of acute diarrhea,2 but access and uptake remain low.
In July 2019, thanks to an application from the Diarrhea Innovations Group, the World Health Organization added co-packaged ORS and zinc to its essential medicines list for children (EMLc), harmonizing with diarrhea treatment best practices and creating an enabling environment for greater access, uptake, and affordabilty of both zinc and ORS. Learn more.
PATH has worked in Kenya, Malawi, Cambodia, and Vietnam to implement an integrated approach to diarrheal disease control that incorporates new technologies with proven interventions like ORS and ORT corners. We are also helping national governments set policies that will remove the threat of diarrhea for future generations.
At ORT corners in rural clinics in Africa and Asia, nurses combine treatment with education, giving mothers immediate access to ORS and clean water while teaching them about hygiene, breastfeeding, and nutrition. We had the opportunity to visit ORT corners in Kenya and Zambia to see the vital role they play in a comprehensive strategy to defeat diarrhea.
We are also working to improve the current formulation of ORS—a proven defense against diarrhea—so that it also promotes fluid and electrolyte absorption, reducing diarrheal symptoms and motivating caregivers to use this lifesaving treatment. Though ORS is a simple, inexpensive, and highly effective means to prevent deadly dehydration, less than half of children with diarrheal disease receive it. This is partly because it does not treat the diarrhea itself, so its effect is not easily seen by caregivers. By adding a diarrheal treatment element to ORS that reduces fluid loss and treats dehydration, we hope that a new formulation will motivate caregivers to see an improved ORS as crucial treatment for their child’s diarrhea.
Read about the latest trends in global access and policy guidelines for ORS and zinc in our state-of-the-field report. Learn about a new effort by PATH and partners to improve access of co-packaged ORS and zinc.
1 Munos MK, Fischer Walker CL, Black RE. The effect of oral rehydration and recommended home fluids on diarrhoea mortality. International Journal of Epidemiology. 2010;39(suppl 1):i75-87.
2 WHO, UNICEF. Clinical management of Acute Diarrhoeal Disease. New York: UNICEF and WHO; 2004.
Photo: PATH/Tony Karumba.