The WHO-reduced osmolarity oral rehydration solution recommended for cholera and all acute diarrhoea differs from the older standard ORS primarily in having a lower:

• A Potassium concentration
• B Total osmolarity and sodium concentration ✓
• C Glucose concentration
• D Citrate concentration

Explanation

Reduced osmolarity ORS contains sodium 75 mmol/L, glucose 75 mmol/L, potassium 20 mmol/L, chloride 65 mmol/L and citrate 10 mmol/L, giving a total osmolarity of 245 mmol/L compared with 311 mmol/L in the old standard ORS, which had sodium 90 mmol/L and glucose 111 mmol/L. The reduction reduces stool output, vomiting and the need for intravenous fluids. Potassium and citrate concentrations are unchanged, so hyponatraemia risk is managed by continuing feeding alongside ORS.

Reference: WHO/UNICEF Joint Statement on Clinical Management of Acute Diarrhoea, 2004 ed.

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Written and medically reviewed by the StethoPrep medical team.