Adiaril®, Picolite®… Oral rehydration solutions are used to prevent and treat dehydration, such as in cases of gastroenteritis. What is it exactly ? How to use and prepare them?
Definition: what is an oral rehydration solution?
An Oral Rehydration Solution (ORS) is a food for special medical purposes, it is not a medicine. This product generally comes in the form of sachets of powder to be dissolved in water. It’s the first-line treatment for diarrhea or acute gastrointestinal in infants and children. To be effective, ORS have a regulated composition. They include:
- carbohydrates (sugars) which contribute to an energy supply, promote the absorption of water in the intestine and modify the taste to facilitate intake in children
- electrolytes (sodium, potassium, chlorides) to correct losses caused by diarrhoea. They contribute to the maintenance of good hydration
- alkalizing agents (citrates, bicarbonates) which reduce the acidity of the body induced by diarrhea and prevent possible acidosis (pathological decrease in blood pH)
What is the trade name of an SRO?
Oral rehydration solutions are marketed by different laboratories. The main ones are: Adiaril®, Picolite®, Fanolyte®, Viatol®, Physiosalt®, Nutribén SRO® (powder for oral solution) and Ydrovit® (as a ready-to-use solution).
When to give it to the child?
In children and infants, rehydration solution should be administered as soon as diarrhea or signs of dehydration occur (ringed and sunken eyes, sunken fontanelles, persistent skin fold when pinching the skin, scarcity of urine, absence of tears, rapid weight loss). It’s about reference treatment for dehydration in a context of diarrhea or acute gastroenteritis in children, the challenge is not to treat the cause of the diarrhea, but to avoid dehydration. In some serious cases, severe dehydration can lead to hospitalization, serious sequelae or even death, especially in children under 3 years old.
When to take it in adults?
The use of a rehydration solution is not systematic in cases of diarrhea in adults because healing is often spontaneous within 24 hours of the onset of symptoms. In addition, dehydration in healthy adults is very rare. In case of moderate dehydration, an oral rehydration solution can be administered, especially among the the elderly particularly sensitive to this phenomenon. The warning signs are mainly a persistent skin pinching, less urine, dry mouth, fatigue and weight loss fast. This dehydration can manifest itself during a acute diarrhea, repeated vomiting, fever or high heat. Faced with severe symptoms such as confusion or hallucinations, urgent hospitalization is required. Particular vigilance with respect to these products is required in patients with cardiac or renal insufficiency. due to water and electrolyte intake. Thus, a medical consultation prior to taking ORS is strongly recommended.
The reconstituted product is to be administered orally, with a bottle in infants and young children. The solution will first be offered ad libitum in small sips on a regular basis, every 5 to 10 minutes then every 15 to 30 minutes. If the child refuses to drink the solution from the bottle, it is possible to make him swallow slowly using a small spoon or pipette (by placing it against the inside of the cheek). In adults, the principle of administration in small quantities at regular intervals remains the same. Regarding the preparation, the powder contained in theThe sachet must be dissolved in a volume of 200 mL of weakly mineralized water (Mont-Roucous, Volvic, Evian…). Nothing should be added to the solution at the risk of modifying the composition and rendering it ineffective. The reconstituted product can be stored in the refrigerator for a maximum of 24 hours, except for the ready-to-use Ydrovit® solution which can be stored for 48 hours after opening.
It is recommended to buy the oral rehydration solution in pharmacies.
How to make a homemade rehydration solution?
To be effective, an oral rehydration solution must contain carbohydrates, electrolytes and alkalizing agents at well-defined concentrations. For this reason, sodas cannot substitute to this type of product because of their high concentration of sugars and their low sodium content. Preparing a homemade rehydration solution is possible, but remains debatable. The preparation protocols available on the Internet do not have an identical composition to that of marketed pharmaceutical products. It is therefore recommended to buy oral rehydration solution in pharmacies in order to have a guarantee on the effectiveness and safety of the product. These products meet strict requirements in terms of manufacturing and control. In case of stock shortages, community pharmacists are authorized to manufacture oral rehydration solutions for their patients, knowing that strict rules govern the production of these magistral preparations.
Sources:
– The High Authority for Health
– French Society of Pediatrics