A recent article published in the New Indian Journal of Pediatrics discussed that comprehensive oral therapy has decreased diarrhea-related deaths in last three decades. ORS has reduced the need for intravenous fluids and consequently hospitalization.

Despite the cost of ORS being low and within the buying capacity of most people in developing countries, it cannot be used with intractable vomiting or diarrhea. ORS does not produce appreciable electrolyte imbalance there is no need of electrolyte estimation for initiation or follow up therapy with ORS solution.

Additionally, certain insights may improve efficacy and acceptance of suitable rehydration solution in the developing world. The keeping quality of the solution after reconstitution in potable water at different temperatures and humidity is not calculated. For 75 mEq/L of sodium the glucose requirement will be 37.5 mmol/L, as two atoms of sodium constitutes a molecule. Addition of resistant starch to OR—as it does not increase the Osmolarity significantly—should be brought under the ambit of research.

ORS has significantly brought down the diarrheal mortality; Reduced Osmolarity ORS is said to bring down the morbidity further. It is a simple effective therapy requiring least scientific skills for administration. The authors reported that although a single formulation is not best at all situations, reduced osmolarity ORS has proven meaningful in all ages; all types of diarrhea irrespective of etiology; all forms of dehydration where it can be used and in different modes of therapy like deficit correction; and maintenance and ongoing loss replacement. Reduced Osmolar WHO-ORS is a significant scientific breakthrough of this century, especially as a treatment modality for diarrhea in children.

Source: New Indian Journal of Pediatrics. 2019;8.3.