Oral rehydration therapy

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Oral rehydration therapy (ORT) is the re-introduction of fluids into the body to treat dehydration. It also covers continued feeding of a dehydrated patient. Rehydration is done with oral rehydration solution (ORESOL).

Administration

There are numerous common diseases that cause a patient to suffer diarrhea such as gastroenteritis, cholera, and dengue. The most immediate effect of diarrhea is dehydration or the loss of water in the body. To arrest the ill effects of dehydration, which could even lead to death, oral rehydration therapy should immediately be administered.

Oral rehydration therapy is especially favorable in a developing country such as the Philippines, where most of the population still does not have access to costly medications and medical facilities. As opposed to intravenous fluid therapy, ORT is cost efficient but just as effective in treating dehydration. The Department of Health (DOH) has listed ORT as the crucial initial treatment for diarrhea caused by the above-mentioned diseases in its health advisory for common diseases in the country.

Administration is basically drinking ORESOL mixed with water. On the other hand, there have been studies that sought other manners of administering ORESOL to make it more appealing and acceptable in large doses to dehydrated patients. Flavored and even rice-based solution was studied if they could enhance ORESOL’s acceptability.

In terms of effectiveness in treating diarrhea, varied studies show that the different types of oral rehydration salts (ORS) enjoy success at different levels. One study shows that polymer (rice)-based ORS has an advantage over glucose-based ORS in treating acute watery diarrhea. Another study, however, shows that giving glucose-based ORESOL to children from one to five years of age who regularly have bouts with diarrhea improved their nutrition even during periods of diarrheal attacks. This may essentially show that in any form, oral rehydration solution is greatly beneficial in arresting the debilitating effects of dehydration caused by diarrhea.

Oral rehydration therapy programs in the Philippines

One noteworthy campaign of the Department of Health (DOH) promoting oral rehydration therapy was “T.K.O. (Tubig, Kubeta, Oresol): Kontra Kolera” in 1995. The said program was launched in the light of the nationwide cholera epidemic. Although, much of the focus was on water sanitation, the campaign was also successful in educating a wider audience on the proper preparation and administration of ORESOL at the onset of diarrhea caused by cholera.

The department continuously procures oral rehydration solution packets for giving away at barangay health centers nationwide. Research is also constantly being done on the improvement its formulation. Administrative Order 2007-0045, issued by the Office of the Secretary of DOH, provides for the “appropriate support and promotion on the use of zinc supplementation and reformulated ORS in the management of diarrhea” in their aim “to contribute to reduced child malnutrition and child deaths through more effective management of diarrhea among young children.” The reformulated ORS has reduced concentration of glucose and salt to avoid the possible effects of hypertonicity (higher osmotic pressure) in fluid absorption.

Due to the increased incidences of dengue this 2010, the DOH reminds parents and caregivers to “encourage the intake of oral fluids like ORESOL, water, juices, etc.” for home treatment of mild dengue cases.

References