The Greatest Medical Discovery You've Never Heard Of
In 1978, The Lancet medical journal called oral rehydration therapy (ORT) "potentially the most important medical advance this century." Despite this, ORS remains underused in many households, even as diarrhoeal diseases continue to kill hundreds of thousands of children globally each year.
In India, diarrhoea remains a leading cause of child mortality. Most of these deaths are preventable with one simple intervention: ORS.
What Is ORS and How Does It Work?
Oral Rehydration Solution is a precisely formulated mixture of glucose (sugar) and electrolytes (primarily sodium and potassium) dissolved in clean water.
The science behind ORS is elegant: glucose and sodium share a transport mechanism in the intestinal wall (sodium-glucose cotransport). When both are present in the right ratio, the gut absorbs them together — and water follows. This mechanism works even during active diarrhoea, when the gut's normal absorption is disrupted.
This is why ORS works when plain water doesn't: drinking plain water during severe diarrhoea can actually worsen electrolyte imbalance. ORS restores both fluid volume and electrolyte balance.
WHO-ORS Formula
The World Health Organization's recommended low-osmolarity ORS contains (per litre of water):
| Component | Amount |
|---|---|
| Sodium chloride (salt) | 2.6 g |
| Trisodium citrate | 2.9 g |
| Potassium chloride | 1.5 g |
| Glucose (anhydrous) | 13.5 g |
| Osmolarity | 245 mOsm/L |
Pre-packaged ORS sachets (available at all pharmacies) contain the ingredients in the correct proportions. Simply dissolve one sachet in the specified amount of clean water.
Home-Prepared ORS
If commercial ORS is unavailable, the WHO recommends the following home formula:
1 litre of clean (boiled and cooled) water + 6 level teaspoons of sugar + ½ teaspoon of salt
Mix thoroughly until dissolved. This is less precise than commercial ORS and should be used only when commercial sachets are unavailable.
Never add extra salt — too much salt can be dangerous, especially in children.
When to Use ORS
ORS is the first-line treatment for dehydration from any cause:
- Diarrhoea (most common use)
- Vomiting
- Fever with heavy sweating
- Excessive exercise in hot weather
- Heat stroke
Signs of Dehydration
Recognising dehydration is critical. Act quickly when you see these signs:
Mild Dehydration
- Increased thirst
- Dry mouth
- Slightly reduced urine output
- Fatigue
Moderate Dehydration
- Sunken eyes
- Decreased skin elasticity (skin tents when pinched)
- Reduced urine (dark yellow)
- Increased heart rate
- Irritability
Severe Dehydration (EMERGENCY)
- Very sunken eyes
- No tears
- No urination for 8+ hours
- Extreme weakness or unconsciousness
- Cold, mottled skin
Severe dehydration requires immediate medical attention and intravenous fluids.
ORS for Different Age Groups
Infants (under 6 months)
- Continue breastfeeding as normal — breast milk has rehydrating properties
- Add ORS in small, frequent sips (5–10 mL every 1–2 minutes)
- Do NOT give plain water to infants under 6 months
Children (6 months – 5 years)
- Give ORS after every loose stool: 50–100 mL for children under 2 years; 100–200 mL for older children
- Continue offering normal food as the child tolerates
Adults
- For mild to moderate diarrhoea, drink at least 3 litres of ORS per day
- Continue eating as tolerated — the old advice of "gut rest" is outdated; food helps repair the gut lining
When ORS Is Not Enough
Seek medical attention if:
- The child has bloody diarrhoea (may indicate bacterial infection requiring antibiotics)
- Vomiting prevents keeping ORS down
- Signs of moderate or severe dehydration appear
- Fever above 102°F (39°C) accompanies diarrhoea
- Symptoms persist beyond 3 days
ORS From Mithilanchal Pharma
Mithilanchal Pharma produces quality ORS sachets formulated to WHO specifications, ensuring accurate electrolyte concentrations in every sachet. Our ORS is manufactured in GMP-certified facilities, providing the reliability you need in a health emergency.