Dehydration

Dehydration

DefinitionDehydration is the condition that results from excessive loss of water from the body. The body requires a certain amount of water and other elements, called electrolytes, to function properly. Fluids are lost through sweat, urine, bowel movements and breathing. Drinking and eating both help to replace fluids, especially drinking. When the body loses too much water and it is not replaced, dehydration sets in.


CausesDehydration occurs when fluid loss exceeds fluid intake. Factors that contribute to dehydration include:

• Vomiting
• Diarrhea
• High fever
• Exposure to the heat and sun
• Excessive exercise
• Medications, including:
• Diuretics (water pills)
• Laxatives
• Inadequate fluid intake due to:
• Mobility problems
• Mental or memory problems
• Decreased thirst perception
• Desire to limit incontinence
• Fluid imbalance caused by illnesses, such as:
• Diabetes mellitus
• Diabetes insipidus
• Lung disease
• Kidney problems
• Burns

Risk FactorsA risk factor is something that increases your chance of getting a disease or condition.

• Age:
• Younger than 2 years old
• 65 and older
• Living in a nursing home
• Neurological conditions, such stroke or cerebral palsy
• Memory problems or dementia
• Chronic medical conditions
• Athletic competition

SymptomsSymptoms vary depending on the degree of dehydration. Dehydration can be extremely serious and life threatening and may require immediate medical care.
Symptoms may include:

• Dry mouth
• Limited tear production
• Thirst
• Weakness
• Decreased urination
• Concentrated urine
• Darker color
• Stronger odor
• Wrinkled skin or tenting when pinched
• Eyes that appear sunken
• Parched, cracked lips
• Dizziness or feeling faint
• Drowsiness
• Nausea
• Irritability
• Confusion
• Fever
• Low blood pressure
• Increased pulse
• Weight loss
• In infants, sunken soft spot in the skull

DiagnosisThe doctor will ask about your symptoms and medical history and perform a physical exam. This will probably include measuring your vital signs. To help provide information for the doctor, keep a diary of:

• Your daily weight
• Number of times you have vomited or moved your bowels
• Your fluid and food intake
• Your urine output
• Recent travel
• Self-treatments you have tried

Tests may include:

• Stool sample – to look for the cause of diarrhea
• Urine tests – to check the urine's concentration
• Blood tests – to check body fluids and body chemistry

TreatmentTherapy aims to rehydrate the body, replace lost electrolytes and prevent complications. If an underlying cause is identified, therapies to treat that condition may be included if appropriate.
Treatment includes:
Fluid Replacement
To help replace fluids:

• Drink a small amount of clear liquid every 15 to 30 minutes. For small children, this may mean 1 teaspoon every few minutes initially.
• Increase the amount of liquid as you can tolerate it.
• Stick with clear liquids for the first 24 hours.
• If you cannot keep any liquids down, try sucking on ice cubes.
• Avoid beverages with alcohol or caffeine, such as coffee, tea and soft drinks. These promote fluid loss.
• Avoid sweetened drinks, fruit juices and gelatin because they can make diarrhea worse.
• If you are unable to adequately replace fluids and your condition does not improve, contact your doctor. You may need intravenous fluids or other medical care.

NutritionDietary modifications include:

• If you have diarrhea but no vomiting, continue eating small amounts of food frequently.
• If vomiting, once you can keep fluids down, slowly and gradually return to a regular diet.
• Eat a well-balanced diet with fruits, starches and fluids.
• Only eat small amounts of red meat and proteins.
• Avoid spicy foods and milk products until your symptoms are gone.

MedicationMedications may include:

• Anti-emetics – used for severe vomiting
• Anti-diarrheal medicine – used for severe diarrhea or abdominal cramping
• Antibiotics – used for severe diarrhea caused by a bacterial infection

If you are diagnosed with dehydration, follow your doctor's instructions.
PreventionTo prevent dehydration:

• Drink plenty of fluids, even if you are busy or sick.
• Drink fluids regularly while exercising or when outdoors on a hot day. Stop frequently for fluid breaks.

RESOURCES:
American Academy of Family Physicians
http://www.aafp.org

American Academy of Pediatrics
http://www.aap.org

CANADIAN RESOURCES:
About Kids Health
http://www.aboutkidshealth.ca

Alberta Health and Wellness
http://www.health.gov.ab.ca/

REFERENCES:

American Medical Association website. Available at: http://www.ama-assn.org/.

Conn's Current Therapy 2001. 53rd ed. WB Saunders Company; 2001.

Keeping dehydrated patients out of the hospital. Patient Care. Feb 1999.

Kleigman RM, Jensen HB, Behrman RE, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.

The Physicians' Desk Reference. The PDR Family Guide Encyclopedia of Medical Care.

Practice of Geriatrics. 3rd ed. WB Saunders Company; 1998.

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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