ORT and vomiting. Reply to Tambawal letter [letter]

Oral rehydration therapy (ORT) can be considered as both curative and preventive with regard to dehydration due to diarrhea. When given to a dehydrated patient, usually in the form of oral rehydration salts, its purpose is to correct (cure) the dehydration by restoring normal amounts of water and salts to the body. However, when given soon after the onset of diarrhea, before dehydration develops, usually as a homemade solution, its purpose is to prevent the reoccurrence of dehydration. Vomiting happens frequently during diarrhea, especially when the illness is caused by rotavirus or cholera. Vomiting can occur, or continue, during the 1st hour or 2 of ORT, after which it will usually diminish or stop. When vomiting occurs during ORT, fluid administration should be continued after waiting 10 minutes but given more slowly in sips at short intervals. Although it may appear that a large amount of rehydration fluid has been vomited, most of what is given is actually retained, benefiting the patient. Antiemetics, such as chlorpromazine should not be given because (i) they have undesirable side effects, such as drowsiness, which can interfere with the continuation of ORT, and (ii) the vomiting will usually subside as ORT is continued. full text