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How to Use ORS Correctly for Diarrhoea in Ghana

By the Aktive Pharmacy team9 min read

Quick answer

To use ORS correctly, dissolve one sachet in the exact amount of clean, boiled or treated water stated on the pack (often 200ml or 1 litre), then sip small amounts frequently after every loose stool. Do not add sugar, salt or dilute it further. See a doctor if diarrhoea lasts more than two days or dehydration signs appear.

  • Always mix ORS with the exact water volume printed on the sachet, never guess
  • Sip small, frequent amounts rather than gulping a large volume at once
  • Discard mixed ORS solution after 24 hours, even if kept in the fridge
  • Sunken eyes, no urine for 6+ hours or extreme sleepiness need urgent medical care
  • ORS replaces lost fluids and salts but does not stop diarrhoea itself

What is ORS and how does it work

Every time you have watery stool, you lose more than water. You lose sodium and potassium, the salts your body needs to keep your heart, muscles and brain working properly, along with a bit of glucose that helps your gut absorb everything back.

Plain water alone does not fix this. It can even dilute the small amount of sodium left in your blood, which is why plain water and ORS are not interchangeable during a bad episode of diarrhoea. ORS is mixed to a precise ratio of glucose and electrolytes that matches what your intestine needs to pull fluid and salts back into your bloodstream quickly, even while diarrhoea is still happening.

This is also why ORS is completely different from antidiarrhoeal medicines like loperamide. Loperamide works by slowing down your gut movement so you pass stool less often. ORS does not stop the diarrhoea at all. It simply replaces what you are losing so you do not become dehydrated while your body fights off whatever is causing it, usually a stomach bug or food and water contamination.

For most people, especially children and the elderly, dehydration is the dangerous part of a diarrhoea episode, not the diarrhoea itself. A child can go from playful to lethargic within hours in hot Ghanaian weather if fluid losses are not replaced. That is the whole point of ORS: small, steady sips of the right mixture, given often, to stay ahead of what the body is losing.

If you are also worried about fever alongside diarrhoea, especially in rainy season, our Malaria Test Kit Buying Guide for Home Use in Ghana explains when to test at home.

How to mix and drink ORS step by step

Getting the mixing right matters more than people think. Too strong and you can make dehydration worse, too weak and it will not rehydrate properly.

  • Wash your hands with soap before touching the sachet or any cup, especially since you are already dealing with a gut infection.
  • Boil water and let it cool, or use water you trust is clean. Do not use water straight from a tap or sachet water you are unsure of.
  • Measure the exact amount printed on the pack, usually 200ml or 1 litre. Do not guess or eyeball it, use a proper measuring cup or bottle.
  • Pour the whole sachet into the measured water and stir until it dissolves completely. Do not split a sachet into smaller amounts of water, that changes the concentration.
  • Sip slowly rather than gulping. A few spoonfuls every few minutes works better than drinking a full cup at once, especially if there is vomiting too.
  • For adults, aim to replace fluids after every loose stool, roughly a cup or more depending on how watery the stool was.
  • For a child, go slower with smaller sips, a few teaspoons every few minutes, and keep offering even if they refuse at first. Breastfed babies should keep breastfeeding alongside ORS.

Make a fresh batch every 24 hours and throw away what is left over, since mixed ORS does not keep well in Ghana's heat. If you are managing this for a child and are not confident on amounts, our pharmacists at our branches can talk you through it.

Types of ORS sachets sold in Ghana pharmacies

Pharmacies in Ghana mostly stock the standard WHO-formula oral rehydration salts, which contain the same balance of glucose and electrolytes regardless of pack size. What differs is the volume each sachet is made up to.

  • Small sachets meant for 200ml of water, useful for a single dose or for topping up a child who has had one loose stool.
  • Larger sachets meant for 1 litre, more economical for adults or for a household managing diarrhoea over a full day.
  • Flavoured versions, often marketed for children, which taste slightly sweet or fruity to make them easier to get down in a toddler who is already refusing fluids.

The formula itself does not change with flavour. A flavoured sachet is not weaker or stronger, it is simply easier to persuade a reluctant child to drink. If you are rehydrating an adult, either size works, you just need to track how many sachets you are using so you mix the right amount of water each time rather than guessing.

Always check the exact water volume printed on the specific sachet you have bought rather than assuming it matches one you have used before, since mixing a 1 litre sachet into 200ml of water makes it too concentrated, and the reverse makes it too weak to help much. If you are not sure which size suits your situation, our pharmacists at our branches can help you pick, or you can contact a pharmacist before you buy.

What result to expect once you start ORS

ORS does not stop the diarrhoea itself, it replaces what the body is losing, so the improvement you are looking for is in the person, not in the stool. Most people start to feel a difference within three to four hours of steady sipping.

Signs ORS is working

  • More energy and alertness, a child who was listless starts asking to play or wanting to sit up
  • The mouth and lips feel moist again instead of sticky or dry
  • Urine becomes pale yellow (not dark or concentrated) and comes at a normal frequency
  • Skin that was pinched and slow to bounce back returns to normal more quickly
  • Less thirst, because the body is finally catching up on fluid

For a baby, a wet nappy every few hours is a good sign the fluids are going in and working. For an adult, passing urine comfortably and without that dark, strong smelling output is the easiest thing to track at home.

Do not expect the loose stools to stop straight away. Diarrhoea can continue for a day or two even while ORS is doing its job well underneath, because the gut still needs time to settle. What matters in those first hours is that the person is not getting weaker, drier or more confused. If anything, they should be a little brighter each time you check on them.

If you see no improvement after several hours of correct ORS use, or the person seems to be getting worse rather than better, it is time to get help rather than wait it out. Our pharmacists at our branches can talk you through what you are seeing if you are unsure.

Warning signs that mean you should see a doctor

ORS handles most ordinary diarrhoea, but some situations need a doctor or hospital rather than more sachets at home. Knowing these signs in advance saves time when it matters.

  • Blood or mucus in the stool. This can point to an infection that needs proper assessment and needs proper medical assessment.
  • High fever, especially above 38.5°C, or fever that will not come down with paracetamol.
  • Persistent vomiting that stops the person keeping ORS down at all, even in small sips.
  • No improvement after two days of correct ORS use, or the person seems to be getting weaker rather than stronger.
  • Signs of severe dehydration: sunken eyes, very little or no urine for six to eight hours, a baby with a sunken soft spot on the head, skin that stays pinched up when gently pulled, or confusion and extreme sleepiness in an adult.
  • Babies under three months with diarrhoea, or any young infant who is refusing to feed.
  • Elderly people with other conditions, such as heart problems or diabetes, who seem drowsy, disoriented or unusually weak.

These are the moments where home treatment should stop and medical care should take over. If you are not sure whether what you are seeing counts as an emergency, contact a pharmacist and describe it, or head straight to the nearest hospital if the person is deteriorating quickly.

Common ORS mistakes to avoid

Most ORS treatment fails not because the mixture is wrong in theory, but because of small habits that quietly undo its benefit. Watch out for these.

  • Adding sugar or salt "to make it work better". The sachet already has the correct balance of salts and glucose. Extra sugar can pull more water into the gut and worsen diarrhoea, and extra salt can be dangerous, especially for children.
  • Using untreated water. Tap water that has not been boiled or well sachet water of doubtful source can introduce the very germs causing the diarrhoea in the first place. Always use water you would be comfortable drinking plain.
  • Guessing the water amount. Pouring "about" 200ml or eyeballing a litre bottle throws off the whole mix. Use a proper measuring cup or a clean bottle with known volume.
  • Stopping once the person feels a bit better. ORS should continue after every loose stool until diarrhoea has fully settled, not just until thirst disappears.
  • Keeping mixed ORS too long. Once mixed, use it within 24 hours and keep it covered. Throw out anything left after that and mix a fresh batch.
  • Treating ORS as the whole answer for a baby. It rehydrates, but it does not treat the underlying cause. Any infant with ongoing diarrhoea still needs a doctor's assessment, not ORS alone at home.

Get the basics right and ORS works exactly as intended: simple and effective.

Frequently asked questions

You can, but the measurements must be exact: roughly one level teaspoon of salt and six to eight level teaspoons of sugar in one litre of clean, boiled and cooled water. Too much salt can be dangerous, especially for children. Because sachets are measured correctly and cheap, buying one from a licensed pharmacy is safer and more reliable than guessing at home, particularly for babies and the elderly.

For infants and toddlers, offer small sips frequently rather than a large amount at once, roughly 50 to 100ml of ORS after every loose stool, more if the child seems thirsty. Use a spoon or cup rather than a bottle if the child refuses to drink. Keep breastfeeding or formula feeds going alongside ORS. If the baby vomits, refuses fluids, or has fewer wet nappies than usual, see a doctor promptly.

ORS is meant for episodes of diarrhoea, vomiting or heavy fluid loss, not as a daily drink. It contains specific salts and sugar levels designed to replace what the body loses during illness, and regular use without need can upset your normal salt balance. Once the diarrhoea settles and normal eating and drinking resume, you can stop ORS. Plain water and a balanced diet are enough for everyday hydration.

Yes, ORS is generally safe in pregnancy and is often recommended for dehydration from diarrhoea, vomiting or morning sickness. It replaces fluids and salts without added risk to the pregnancy when used as directed on the pack. That said, pregnant women should see a doctor or midwife quickly if diarrhoea or vomiting is severe, persistent, or accompanied by dizziness, reduced urination or abdominal pain.

Plain water replaces lost fluid but not the salts and glucose your body loses during diarrhoea or vomiting, which is why water alone will not fully correct dehydration. ORS contains a balanced mix of sodium, potassium and glucose that helps your gut absorb fluid more effectively and restores the body's salt balance. This is why ORS, not just water, is the recommended first step for diarrhoea in Ghana.

Not sure which one is right for you?

If diarrhoea has started, pick up an ORS sachet today and begin sipping small amounts after every loose stool, following the mixing instructions on the pack. You can order ORS for Yango delivery across Accra, collect it free from our Lakeside Estate Community 6 or Community 8, Ashaley Botwe branches, or message a pharmacist on WhatsApp if you are unsure which type suits a child, an elderly relative or yourself.

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This guide is general information from Aktive Pharmacy (Aktive Plus Healthcare Limited, Pharmacy Council licence PC/GR/WR/0201J). It is not a diagnosis and does not replace advice from your doctor or pharmacist. Always read the leaflet. If symptoms are severe, getting worse, or you are pregnant, breastfeeding, buying for a child or have a long-term condition, speak to a pharmacist or doctor first. In an emergency, go to the nearest hospital.

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