Wednesday, February 04, 2009

Oral Rehydration Solution -- Homemade Pedialyte Substitute -- Electrolyte Replacement Solution -- for Vomiting or Diarrhea

A couple of weeks ago I caught a stomach bug that's been going the rounds in our town. I needed electrolyte replacement so mixed up a batch of the World Health Organization's Rehydration Solution. This doctor-approved recipe replaces all essential electrolytes with simple ingredients that, with one possible exception, are already in most kitchens.
Oral Electrolyte Replacement Solution Ingredients
I was very glad we already had the potassium chloride (salt substitute) right there in the cupboard. I was even more glad that very slowly sipping one glassful was enough to turn things around so that I could then switch to water and apple juice. Ah, but that one glassful tasted delicious...which tells you how much it was needed.

Here's the recipe for anyone else who might pick up a (not so) lovely stomach bug:

WHO Oral Rehydration Solution

Table Salt (NaCl) 1/2 tsp.*
Salt Substitute (KCl) 1/2 tsp.*
Baking Soda 1/2 tsp.
Table Sugar 2 tablespoons
Tap Water 1 Liter (= 1 Qt. 2 tablespoons)

Chill. Can be served with fresh lemon squeezed into it. One can also mix it with Crystal Light or "sugar-free Kool-Aid" - don't use Regular Kool-Aid as it takes extra sugar which can worsen diarrhea.

This tastes quite salty to someone who isn't dehydrated.


NOTE: *Morton's Salt makes that is half NaCl (table salt) and half Potassium salt (KCl) and is called "Lite Salt" - if that is what your grocery store has, simply use 1 teaspoon of the the Lite Salt in place of of the table salt and potassium salt.

I highly recommend
1) copying down this recipe and putting it where it'll be easy to find when you need it and
2) getting some potassium containing salt substitute--add it to your shopping list now so that it is there when you need it!


The doctor says

"Have small children start with 1 teaspoon every 5 - 10 minutes, which is usually quite well tolerated. The amount can be increased every 30 - 60 minutes (2 teaspoons, 3 teaspoons, 2 tablespoon, etc. every 5 - 10 minutes). "


See a physician if any of the following occur:

1. No urine output in 8 hours,

2. No tears with crying,

3. Excessive thirst,

4. Dry mucus membranes in the mouth,

5. Persistent vomiting and/or diarrhea,

6. Abdominal pain, especially abdominal pain that settles in the right lower abdomen.


Keyword: Pedialyte Substitute, Abdominal Pain, Vomiting, Diarrhea, Dehydration, Rehydration, Electrolyte Replacement

Oral Rehydration Therapy Part Two...or...dealing with Diarrhea

(written by a Family Practice/Emergency physician)

The electrolyte solution (see recipe above) typically tastes REALLY good ... when you actually really need it and is the preferred oral rehydration fluid because the potassium (which gives it the 'flavor') and sodium in it cause 'active transport' of fluid across the small bowel wall and into the blood stream.

I mix the rehydration solution with Crystal Lite (or generic) beverage powder to help the palatability issues as well. Sugar-free KoolAid and other similar beverages also work -but don't use any powdered beverage that requires sugar or you will be very disappointed or will have to use way more sugar than you should. Why not just use more sugar you ask? After all it IS a natural product. Well, too much sugar in a beverage (as occurs with soda, Gatorade and all sports drinks that need to provide 'quick energy') causes an increase in the osmotic content of the beverage. A high osmotic level is the principle behind GoLytely, the colon prep for colonscopy procedures. Therefore, avoid sports drinks and other beverages with sugar in them while ill and convalescing from gastrointestinal viral illnesses causing vomiting and diarrhea.

Additionally, even when vomiting actively, about 1/2 of the fluid consumed IS absorbed even though it 'looks like nothing stayed down." So keep taking fluids frequently in small amounts. I recommend starting with 1 teaspoon of clear liquids (which do not include soda or sports beverages of any sort preferrably as they can worsen diarrhea - see above) every 5-10 minutes. Increase the amount of fluid by 1 teaspoon at at time every 1/2 to 1 hour. If you get nauseous or vomit, back off to the last volume that worked and keep going. Over a few hours one can get up to taking an ounce or more at a time, which will effectively provide 180-360 ml of fluid per hour - as much or more than a physician would prescribe by intravenous route.

Finally, remember "LACTASE". Why? It sounds so innocuous. Here is why. This digestive enzyme sits like the 'frosting on the cake' in one's small bowel ready to help break down dairy products that we eat. Yes, it is just resident on the surface of the bowel lining. So, imagine taking a hose, even at a low spray force to a birthday cake. Even if the cakes survives, the frosting is quickly swept away. So it is with the Lactase lining or coating of the surface of the bowel after repeated episodes of diarrhea--it's gone. You have just lost the ability to digest any dairy products effectively for a couple days AFTER the last diarrhea stool until more lactase is formed. So avoid ALL dairy products including cheese, ice cream, milk, yogurt (I'm sure I missing some) during and for a couple days after your diarrhea spells.

OK. Say you didn't know or ignored my advice on dairy. What then? OK, here is what happens. The dairy that you eat gets curdled by the acids in the stomach and make their way to your small bowel where ... nothing happens. (Remember in usual state of health the lactase enzyme splits the lactose sugar molecule into smaller sugar molecules that your body can absorb - but lactase is 'missing in action'). So your dairy continues on its journey through your GI tract until it hits your ... large bowel. There it meets up with its friends - colon bacteria including E. coli and others. These bacteria LOVE dairy products that contain undigested lactose!!! They jump right in and start splitting up the lactose molecules into the basic building blocks of life: Oxygen, Hydrogen, Nitrogen, and sugars.

And what is wrong with that? Nature is providing the built-in back up system, the dairy gets digested, the bacteria are healthy, fat and happy. Where's the problem? Oops. The by products of the bacteria who have had a happy feast are ... GASES!!! They also created double doses of sugar in the large bowel where they cause ... osmotic diarrhea because there are at least two molecules of sugar for every molecule of dairy. They also cause bloating and cramping and ... gas (yes, THAT gas - flatus).

See, wouldn't have just been better if you avoided dairy products for a couple of days after your diarrhea stopped?