E-drug: Re: Oral rehydration salts (ORS) - formulation (cont'd)
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Dear E-druggers,
I don't wish to comment about the formulation of ORS but rather add a few
words about home fluids using fluids with amino-acids. Research has shown
that the "pump" that acts with glucose and sucrose when they are included
to increase the uptake of fluids 25-fold is also there with any fluid
containing amino-acids; i.e. virtually any thin fluid that is made from a
staple such as maize, rice, wheat, sorgum, millet etc with a little salt
will act as well as ORS. Some such a rice-based fluids have been show to be
superior in action to ORS (the only common staples that are not suitable
are those which are pure starch or other carbohydrate such as cassava or
plantain bananas).
The advantages of such an amino-acid containing fluid in the home setting
are fairly obvious namely:
1. It is readily available even in most poor communities
2. It is cheaper and in the long run more sustainable
3. It gives some small nutrition as well as rehydration
4. Many have a slight slowing effect on the diarrhoea
5. Mothers know how much salt this should contain to avoid over-use
of salt since they have knowledge of how salty a gruel should be.
Sugar/Salt solutions or ORS can be made too concentrated since no-one has
the tradition of drinking this to know how salty it should taste.
6. It may well strengthen certain local customs that are already in use
7. It tastes better and can be more accepted by a child who is nauseated
8. The fluid is always boiled on preparation which increases its safety
Recipe for rice-based ORS: 30-50 gms ground rice; 3 gms salt; 1 litre
water. Let it boil for 10 minutes before cooling and drinking.
I hope this will help a few to broaden their horizons to the value of the
bottom-up approach.
Gunnar Holmgren,
Consultant in International Health Care, Section for International Maternal
and Child Health, Uppsala University, Sweden
Gunnar.Holmgren@ich.uu.se
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