Oral Rehydration Therapy, or ORT, is a simple, cheap, and effective treatment for diarrhea caused by, e.g., cholera. According to The Lancet (1978), ORT is "potentially the most important medical discovery of the 20th century".

Various diseases cause damage to the intestine, allowing water to flow from the blood into the intestine, depleting the body of both fluid and electrolytes. Simply drinking water is ineffective, so the standard treatment is to restore fluids intravenously. This requires trained personnel and materials which are not sufficiently available in the Third World. However, it was discovered that the body can absorb a simple solution containing both sugar and salt. The dry ingredients can be mixed and packaged, and then the solution can be prepared and delivered by people with minimal training.

History

ORT was developed in the late 1960s by researchers in India and Bengladesh (then East Pakistan), for the treatment of cholera. The Indo-Pakistani War of 1971 provoked a public health emergency in the refugee camps set up to house those fleeing the violence. With cholera spreading rapidly and death rates rising, the head of a medical centre in one of the camps instructed his staff to distribute Oral Rehydration Salts (ORS). In the refugee camps where ORS was being used the death rate was only 3%, compared to 20–30% in those camps using only intravenous fluid therapy.

Between 1980 and 2000, ORT decreased the number of children under five dying of diarrhea from 4.6 million worldwide to 1.8 million—a 60% reduction.

In 2002, Drs. Norbert Hirschhorn , Dilip Mahalanabis , David R. Nalin , and Nathaniel F. Pierce were awarded the first Pollin Prize for Pediatric Research , in recognition of their work in developing ORT.

Treatment

One standard remedy is the WHO/UNICEF glucose-based Oral Rehydration Salts (ORS) solution. WHO/UNICEF ORS solution contains

• 75 mEq/l of sodium and
• 75 mmol/l of glucose,
• 65 mEq/l chloride,
• 20 mEq/l potassium,
• 10 mEq/l citrate,

and has a total osmolarity of 245 mOsm/l.

An inexpensive home-made solution consists of

• 1 liter of water, mixed with
• 8 teaspoons of sugar,
• 1 teaspoon of table salt.

A half cup of orange juice or half of a mashed banana can be added to each liter to add potassium and improve taste.

If commercial solutions are used, true rehydration solutions should be used and sports drinks should be avoided (especially in younger children) as these solutions contain too much sugar and not enough electrolytes.

External links

• Rehydration Project
• Johns Hopkins Public Health, Spring 2003
• "Reducing deaths from diarrhoea through oral rehydration therapy", Bulletin of the World Health Organization, 2000, 78 (10)
• Rainbow Pediatrics Knowledgebase: The Oral Rehydration Therapy