Dehydration: How To Recognize And Prevent Its Effects
Dehydration can be defined as “the excessive loss of water from the body.” Diseases of the gastrointestinal tract can lead to dehydration in various ways. Often, dehydration becomes the major problem in an otherwise self-limited illness. Fluid loss may even be severe enough to become life-threatening.
The following information is designed to provide some understanding and guidance in order to avoid the effects of dehydration. Treatment,however, should be individualized, and your physician should be contacted before using any of the measures outlined here.
Our bodies require a certain amount of fluid intake on a daily basis to function; the minimum is about equal to four 8 ounce glasses (one liter or one quart). Requirements vary with activity and age, but most active persons need two to three times this basic amount. Basic fluid intake serves to replace the fluids which are required to perform our normal bodily functions. If we take in less or lose more fluid than is needed, the end result is dehydration.
Excessive loss of fluid through the intestinal tract can happen when the intestine is “inflamed” or damaged, or when bacteria or viruses cause the lining of the intestine to produce more fluid than can be absorbed.
Abnormal connections that are between parts of the intestinal tract (fistula) may also lead to fluid depletion. A decrease in oral liquid intake may be due to nausea or loss of appetite; this may be worsened by an inability to keep things down (vomiting). Medications also can cause an increased fluid loss. Prior bowel resection or ileostomy can make a person more susceptible to dehydration.
A reliable clue to indicate dehydration is a rapid drop in weight. This loss may equal several pounds in a few days (or at times hours). A rapid drop of over 10% (fifteen pounds in a person weighing 150 pounds) is considered severe. Symptoms may be difficult to distinguish from those of the original illness, but in general, the following signs are suggestive of dehydration; increasing thirst, dry mouth, weakness or lightheadedness (particularly if worsening on standing), darkening of the urine, or a decrease in urination. Severe dehydration can lead to changes in the body’s chemistry, kidney failure, and can even become life-threatening.
The best way to treat dehydration is to prevent it from occurring. If you suspect excessive fluid loss during and illness, your physician should be notified. Intravenous or oral fluid replacement may be needed, depending on severity of fluid loss. In the 1960’s the World Health Organization (WHO) developed an oral solution containing sugar, which improved the absorption of salt/water preparations, saving the lives of many dehydrated persons in remote areas. This solution can be prepared at home by mixing the following:
- Table Salt - 3/4 teaspoon
- Baking Powder - 1 teaspoon
- Sugar -4 tablespoons
- Orange juice - I cup
- Water - I quart/liter
This beverage can be taken in small, frequent sips, and is often tolerated in the face of nausea and vomiting. Several commercial preparations are available, but since their composition varies, your physician should be contacted to decide which replacement solution (if any) is best. Changes in the type or amount of fluid replacement may be needed as symptoms improve. Care must be taken to avoid using these solutions improperly.
Food intake should be continued if at all possible, except for high fiber fruits and vegetables. There is controversy regarding ingesting milk products since the ability to absorb milk sugar (lactose) may be reduced. The prior policy of “bowel rest” seems to do more harm than good except in certain circumstances.
Dehydration in Children
Only a physician can diagnose dehydration, but parents can watch for some obvious signs: a dry mouth, no tears, sunken eyes, a reduction in urination, and skin that stays compressed when pinched.
The American Academy of Pediatrics guidelines are:
* For diarrhea with no dehydration, feed the child normally and give supplemental commercial rehydration fluids within four to six hours after a diarrheal episode. If the diarrhea persists, call the child's doctor. * For diarrhea with mild dehydration, take the child to a physician. The child should be given oral rehydration fluids in the doctor's office, with food and rehydration fluid continued at home. * For moderate or severe dehydration, the child should be treated in a health-care facility. Moderate dehydration may be treated orally, but severe dehydration requires intravenous fluids.
The old advice to let the intestine “rest” after a bout with diarrhea is now not recommended by AAP.
Portions of the above information was provided with the kind permission of the Food and Drug Administration