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Home-made rehydration solution for the management of diarrhea

This question was posted the Prevention and treatment of moderate acute malnutrition forum area and has 2 replies.

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Edem

Normal user

20 Jul 2019, 11:47

Dear Colleagues,

I ask this question on behalf of another colleague who wrote and I quote:

“We have always been taught that, in the absence of ORS, a home-made rehydration solution should include sugar and salt. However, I was looking today at the BMA Family Doctor Home Adviser (2001) and it advises sugar only (salt is not mentioned). What do you make of this? (In terms of life-saving, perhaps there is a case for sugar-only because the incorrect amount (ie too much) salt could do more harm than good?)”

Thank you for you contribution. 

Paul

Frequent user

22 Jul 2019, 14:19

Hi Edem,

You are right in so much that too much salt would be harmful, however the purpose of adding salt is to replace salt lost through diarrhoea, for example. Commercial ORS also contains other electrolytes but this would not be easily made at home. In short, salt (in the recommended amounts) is necessary to make home made ORS.

From WHO:  "In case ORS packets are not available, homemade solutions consisting of either half a small spoon of salt and six level small spoons of sugar dissolved in one litre of safe water, or lightly salted rice water or even plain water may be given to PREVENT or DELAY the onset of dehydration on the way to the health facility. However, these solutions are inadequate for TREATING dehydration caused by acute diarrhoea, particularly cholera, in which the stool loss and risk of shock are often high."

I havent read the BMA publication so cannot comment. The current advice from the national health service in the UK is to use standard ORS for diarrhoea.  Commercial ORS formulations are readily available on the high street. 

The rehydration of children with severe acute malnutrition (SAM) however, would not use standard ORS but would use a specialised formulation under careful medical supervision (ReSoMal or Low Osmolarity ORS depending on the underlying cause of the dehydration). If the child with SAM is dehydrated (but concious) then using sugar water, without the salt would be OK to use during transport to a medical facility for proper treatment. 

I hope this helps

Edem

Normal user

24 Jul 2019, 20:28

Thank you Paul for your response. I am grateful. 

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