The most critical therapy in diarrheal illness is rehydration, preferably by the oral route, with solutions that contain water, salt, and sugar
Use Oral rehydration solutions.
The proportions of water and electrolytes in oral rehydration solutions (ORS) are essential for effective rehydration. Here's a basic recipe for homemade ORS:
1. **Water**: Use clean, safe water. Boiled and cooled water is ideal.
2. **Salt (Sodium)**: Add 1/2 teaspoon (2.5 grams) of salt. Sodium helps retain water and maintain fluid balance.
3. **Sugar (Glucose)**: Add 2 tablespoons (about 25 grams) of sugar. Glucose facilitates sodium absorption and provides energy.
Remember, this homemade ORS is not a substitute for professional medical advice. If you or someone experiences severe dehydration, consult a healthcare provider promptly. 🌟
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Oral rehydration solutions (ORS), including standard World Health Organization ORS or commercial ORS, such as Rehydralyte and Ceralyte, may be more appropriate in patients with more severe diarrheal disease. They should be used both to replete a volume depleted patient and also to maintain adequate volume status once replete.
Composition of available ORS are discussed elsewhere. (See "Oral rehydration therapy", section on 'Commercial and standard oral rehydration solutions' and "Oral rehydration therapy", section on 'Oral rehydration solution properties for water absorption'.)
ORSs were developed following the realization that, in many small bowel diarrheal illnesses, intestinal glucose absorption via sodium-glucose cotransport remains intact. Thus, in diarrheal disease caused by any organism that depends on small bowel secretory processes, the intestine remains able to absorb water if glucose and salt are also present to assist in the transport of water from the intestinal lumen. Oral rehydration therapy is grossly underutilized in the US where health care providers tend to overuse intravenous hydration.
Adults with severe hypovolemia should initially receive intravenous fluid repletion. Once they are replete, they can be switched to oral rehydration solutions. (See "Maintenance and replacement fluid therapy in adults".)
Some UpToDate contributors also favor intravenous fluid administration in patients with bloody diarrhea and suspicion for Shiga-toxin producing E. coli infection. This is discussed in detail elsewhere. (See "Shiga toxin-producing Escherichia coli: Microbiology, pathogenesis, epidemiology, and prevention".)
Patients who have bothersome symptoms may benefit from symptomatic pharmacologic therapy.
Antibiotic therapy is not indicated in most cases since the illness is usually self-limited. Nevertheless, empiric and specific antibiotic therapy may be appropriate in certain s
Patients who have bothersome symptoms may benefit from symptomatic pharmacologic therapy.
Antibiotic therapy is not indicated in most cases since the illness is usually self-limited. Nevertheless, empiric and specific antibiotic therapy may be appropriate in certain situations, mainly in patients with severe disease, with symptoms and signs suggestive of invasive bacterial infection, or at high risk for complications (algorithm 1).