Oral Rehydration Solutions

By Carol Ireton-Jones, PhD, RDN, CNSC, FASPEN

Every year you hear the same thing – “it’s gonna be a hot one”.  When it’s hot, we sweat – and lose more fluid than usual – too much fluid loss causes dehydration.  Even usual exercise in the heat can cause excess fluid to be lost from the body.  With Short Bowel Syndrome (SBS) or Intestinal Failure (IF), fluid is also lost through diarrhea, high ostomy output or vomiting.  Thirst isn’t always the first symptom – but it is one important symptom.  Other symptoms include: decreased urine output and or dark colored urine (urine should be light yellow), feeling faint or dizzy, dry mouth, fatigue, and confusion.  Dehydration effects your kidneys negatively and chronic dehydration can cause kidney damage.

The best treatment is prevention!!  Drink plenty of fluid – but when the GI tract doesn’t work well as in SBS or IF – 

water is not the best fluid to use for hydration!   Water is

hypotonic (low amounts electrolytes sodium potassium and chloride).  The fluid in the body is not hypotonic so when water goes into the GI tract, more fluid is produced as the body adds more electrolytes (sodium) into the GI tract trying to reach equilibrium (balance).  This may cause

diarrhea and even more fluid loss!

The best fluid to drink is called Oral Rehydration

Solution (ORS). The World Health Organization (WHO) developed ORS therapy to treat and prevent dehydration from diarrhea throughout the world.  The ORS contains sodium, a small amount of sugar or glucose, and often some potassium and citrate. The content and recipe is important and should meet the WHO, 2001 Guidelines. There are commercial ORS products and homemade recipes for ORS.  Most sports drinks are inadequate in electrolytes and have too much or too little glucose (sugar).  The ORS is important and should be carefully selected.  Sip the ORS throughout the day – usually ~1 liter per day based on your clinician’s recommendations.  Most people receiving home parenteral nutrition (HPN) use 1 to 2 liters per day of ORS.

Nutrishare has identified commercial products that meet the WHO, 2001 Guidelines.  Make sure to get in adequate ORS daily – determine your needs, log it, set reminders if you have to, and stay hydrated!  Talk to your Clinician if you have questions!