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Importance of ORS to control Diarrhea

Importance of ORS to control Diarrhea

by: Dr. Sorabh Goel
Consultant - Neonatology-Paras Bliss, Panchkula

Diarrhea, by definition, is the passage of loose stool in more numbers than the usual. Frequent passing of formed stools is not diarrhea, nor is the passing of loose, “pasty” stools by breastfed babies. Diarrhea is the third leading cause of childhood mortality in India, and is responsible for 13% of all deaths/year in children under 5 years of age, killing an estimated 300,000 children in India each year. It is both preventable and treatable. Diarrhea is a leading cause of malnutrition in children under five years old. Measures for prevention of diarrheal diseases include the use of safe water, hand-washing, food safety, safe disposal of excreta, promoting exclusive breastfeeding and immunization against measles and Vitamin A supplementation in children aged 6-59 months.

What the main causes of Diarrhoea in children?

Disturbed intestinal absorption of fluids is the basis of all diarrheas. Most common cause of diarrhea is viral infections. Other causes include bacterial infections, food allergy, diseases of intestine interfering with the absorption of food. Diarrhea can last several days and can leave the body without the water and salts that are necessary for survival.

How is Diarrhoea managed and treated in children?

Current guidelines for management of diarrhea by the Ministry of Health and Family Welfare, Government of India, recommend low osmolarity oral rehydration salt solution (ORS), zinc and continued feeding of energy dense feeds in addition to breastfeeding. Oral rehydration therapy (ORT) with ORS remains the cornerstone of appropriate case management of diarrheal dehydration and is considered the single most effective strategy to prevent diarrheal deaths in children.

Oral Rehydration Solution (ORS) – How it helps in treating and managing Diarrhoea?

ORS does not stop the diarrhea, but it replaces the lost fluids and essential salts thus preventing or treating dehydration and reducing complications and death. The glucose contained in ORS solution enables the intestine to absorb the fluid and the salts more efficiently. If glucose (also called dextrose) is added to a saline solution, the glucose molecules are absorbed through the intestinal wall – unaffected by the diarrhoeal disease state – and in conjunction, sodium is carried through by a cotransport coupling mechanism. This occurs in a 1:1 ratio, one molecule of glucose co-transporting one sodium ion (Na+). It should be noted that glucose does not co-transport water – rather it is the now increased relative concentration of Na+ across the intestinal wall which pulls water through after it. This way ORS containing a specific concentration of glucose and salt helps to correct dehydration without worsening of diarrhea.

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