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Summary

Dehydration is a loss or decrease in the amount of water content in the body. Our body needs water for every reaction taking place in it. Hence, a lack of adequate water will affect these reactions that may lead to significant consequences like a decrease in blood volume, reduction in the urine output, fatigue and others. Dehydration can occur due to insufficient water intake, prolonged heat exposure, infectious diseases that cause vomiting or diarrhoea and excessive sweating due to heavy exercise. Dehydration can be easily identified by observing characteristic signs and symptoms like restlessness, irritability, extreme thirst and a decrease in urine output. Treatment should start as soon as symptoms are evident. Fluid in the form of an oral rehydration solution containing glucose along with salts of sodium, potassium and chlorine helps in maintaining the water-electrolyte balance in the body. Prompt treatment usually reverses dehydration but if the symptoms are ignored, it can lead to complications like low blood pressure, liver and kidney failure, unconsciousness and in severe cases, it can be life-threatening.

  1. What is dehydration
  2. Dehydration symptoms
  3. Dehydration causes and risk factors
  4. Dehydration prevention
  5. Diagnosis of dehydration
  6. Dehydration treatment
  7. Dehydration prognosis and complications

The loss of water from the body to abnormal or harmful levels is known as dehydration. This disturbs the normal working of the body as water is necessary for every physiological function right from breathing to producing hormones. Although dehydration can occur due to multiple causes, diarrhoea is the most common cause, especially in children and in people living in developing countries. Sometimes, it’s difficult to identify the cause of dehydration, but therapy to recover the lost fluids should be started as soon as possible. Rehydration therapy helps in avoiding further complications and also prevents organ damage. In summers too, dehydration is very common due to a prolonged exposure to heat when outdoors. Hence, the best way to prevent dehydration is to take adequate amount of water and fluids and watch out for any signs of dehydration.

As water is necessary for the processes taking place in the body, dehydration can result in many signs and symptoms:

  • Restlessness and Irritability
    One may feel uneasy and irritable for no reason. This symptom is one of the typical signs of dehydration. (Read more - Irritability symptoms and causes)
  • Sunken eyes
    This is mostly seen in the case of children. The eyes look as if they are deep set and sunken into the face.
  • Extreme thirst
    This is the most common feature of dehydration that even you might notice. You may feel very thirsty. This problem is typical to the cases of dehydration and is a result of the body’s mechanism to balance the fluids. Feeling thirsty makes one drink water and this eventually replenishes the lost water content in the body.
  • Decreased frequency of urination or dark-coloured urine
    Due to a decrease in water content in your body, your urine output may decrease, or you may notice dark yellow coloured urine as it is concentrated due to lack of water.
  • Headache
    You may experience a headache due to a decrease in water level of the body. This symptom is more common after taking alcohol as it is one of the reasons for a dehydrated body.

Causes

Dehydration may occur due to:

  • Heat stroke
    Exposure to the sun for a long duration, especially during the afternoon and not taking enough water or fluids can cause a heat stroke in such conditions. This is very common in construction workers, traffic police, workers involved in laying roads, farmers and people who do not protect themselves from the sun while travelling from one place to another.
  • Diarrhoea
    Diarrhoea or loose motions i.e., passage of unusually loose or watery stools at least three times in a 24-hour period occurs most often due to an infection of the digestive tract on consuming food or water contaminated by microorganisms like bacteria, viruses or parasites. As a result, a lot of fluid is lost from the body through stools.
  • Excessive alcohol intake
    Drinking excessive alcohol can lead to a loss of water from the body as alcohol affects the antidiuretic hormone, which helps in the absorption of water from the kidneys. Hence, urination increases. Secondly, alcohol can also induce vomiting, which can cause loss of water and electrolytes.
  • Insufficient water intake
    Usually, a daily intake of 3-4 litres of water is recommended, but sometimes this need is not fulfilled. The reason may be the lack of availability of water or a habit of drinking less water or simply a lack of thirst.
  • Heavy exercise
    Heavy exercises lead to water loss through sweating. If adequate hydration is not maintained during sweating, it can lead to dehydration.
  • Vomiting
    Frequent vomiting due to any reason (acidity, food poisoning, gastric or peptic ulcers, a side effect of drugs like analgesics, antibiotics, anticancer drugs among others) can result in the loss of water and nutrients from the body.
  • Severe burns
    In people with severe burns, where damage to the thick layer of the skin occurs, seepage of body fluid occurs from the wounds as the protective skin layer gets damaged leading to dehydration.
  • Miscellaneous
    There are some other conditions which can lead to dehydration like uncontrolled diabetes, where patients have a higher frequency of urination, and infections like typhoid, where patients suffer from both vomiting and diarrhoea.

Risk factors

Several factors have been found to increase the risk of dehydration. These are:

  • Drinking less water
    People who have a habit of drinking less water are at a higher risk of developing dehydration. Normally 3-4 litres of water is required by our body every day.
  • Workers working in extreme heat
    Workers involved in road making, construction of buildings, and coal mines, which are exposed to very high heat are at a risk of dehydration through excess sweating.
  • Summer season
    Children playing outdoors and people not using protection against the sun in the summer can be at risk of getting dehydrated due to a heat stroke.
  • Bottle fed babies
    They have higher chances of developing diarrhoea because of unclean bottles that are used for feeding.
  • Flies
    They can bring germs to uncovered food thus causing contamination resulting in diarrhoea after its consumption.
  • Drinking contaminated water
    Drinking water without boiling or filtering can allow an infection to directly enter the body thus upsetting the digestive system.
  • Unclean food, milk, unclean hands & soiled utensils
    This can lead to the growth of infection, which enters the gut causing diarrhoea.
  • Malnourishment
    Malnourished children tend to have a low immunity and are more prone to getting infections, which may result in diseases like diarrhoea, shigellosis, cholera among others. These diseases are associated with a significant loss of water content from the body.

Prevention of dehydration is very easy. This includes inculcating healthy habits and immunization:

  • Maintaining hydration
    Maintaining an adequate water intake by drinking 3-4 litres of water a day and even higher in summer and during heavy exercises can prevent dehydration.
  • Protection from the extreme summer heat
    Using scarves, sunglasses, long-sleeved cotton clothes, summer coat, summer socks, hand gloves and drinking fluids or water frequently in the summer season can protect the body from water loss.
  • Avoid alcohol consumption
    It is one of the commonest causes of dehydration; avoiding alcohol can prevent dehydration.
  • Using sanitary latrines
    Always use hygienic latrines for urination and dumping. Avoid taking a dump in open space which increases the chances of infection.
  • Keeping food and water clean
    Always wash fruits and vegetables before eating. Also, cook them thoroughly to kill disease-causing microorganisms like bacteria, viruses, fungi, and spores. Drinking water should always be kept in clean containers and never stored for more than two days. Decontamination of water by filtration or bringing it to a rolling boil for at least one minute (3 minutes in high altitudes) can be done to make it suitable for drinking.
  • Washing hands before eating & after using a toilet
    Maintaining hygiene by washing hands after using toilets and before handling food can help in decreasing the chances of food contamination, thus preventing diarrhoea.
  • Rota vaccine
    The Rotavirus vaccine should be given to children less than five years of age. Rotavirus is the most common cause of death due to dehydration and diarrhoea in children of this age group.
  • Promote exclusive breastfeeding
    In the case of babies, exclusive breastfeeding can help increase their immunity and decrease the chances of infection.

Diagnosis is made usually based on the clinical signs and symptoms of the person. Your doctor will take a detailed history including habits, personal,, medical and professional history. Signs of dehydration like sunken eyes, irritability, dry skin and low blood pressure help in making the diagnosis. Sometimes laboratory tests may be required. These include:

  • Stool examination
    In the case of diarrhoea, stool examination with a microscope can assist in identifying the infection-causing agent. A stool culture might be needed in some cases.
  • Blood tests
    Blood tests may be advised in certain cases to detect::
    • Infection
      For some suspicious infections like typhoid, a blood test known as Widal’s test can be done for diagnosis.
    • Serum Electrolytes
      Estimation of serum electrolyte concentration can help in determining the sodium and potassium levels in your body. 
    • Complete blood count
      To check for an increase in white blood cell count, which is generally seen in infections. 
    • Random blood sugar
      If your doctor suspects diabetes, random blood sugar test may be needed.

Dehydration can be treated by giving fluids, which is called rehydration therapy. This therapy aims to restore the water content in the body. Assessing the severity of dehydration and finding the cause early is important for recovery.

Home remedies for recovery from dehydration

  • Sugar salt solution
    When ORS is not available, it can easily be made at home by adding 6 level teaspoons of sugar and half level teaspoon of iodized salt in one litre of boiled water that has been cooled. It acts in the same manner as ORS.
  • Green banana diet
    Using green/unripe banana in food can be helpful in reducing the duration of loose motions, which can further help in preventing dehydration. They also help in weight gain in malnourished children.
  • Coconut water
    It is very useful in cases of heat stroke, diarrhoea and vomiting to recover fluid and electrolyte loss.
  • Cold sponging
    To lower the body temperature in people suffering from a heatstroke, frequent cold-water sponging of the whole body is helpful.
  • Rest
    In the case of dehydration due to heavy exercise, complete rest along with maintaining fluid and electrolyte balance of the body is the treatment of choice.

Medical treatment for dehydration

  • ORS (Oral Rehydration solution)
    It is lifesaving when used timely and in adequate quantities. It is a balanced mixture of glucose and electrolytes like sodium, potassium, and chloride. The glucose of ORS is absorbed by the small intestine, and along with it, sodium is also taken up. As a result, the concentration of sodium in the cells increases leading to a passive absorption of water. Hence, it helps in maintaining the desired balance of water and electrolytes in the body. It aids in rapid recovery from dehydration. It is available in medical stores as a one-time use packet. You need to mix this packet in one litre of boiled and then cooled water and drink a few sips after small intervals within 24-hours and discard the solution that is left thereafter.
  • Zinc supplementation
    Zinc supplementation is beneficial in cases of diarrhoea. Some clinical studies concluded that daily zinc supplementation can prevent the worsening of diarrhoea. Hence, early recovery can help in improving water and electrolyte balance and also avoid further loss of water from the body.
  • Use of probiotics
    Probiotics are available in the form of a solution or powdered sachet containing healthy bacteria like Lactobacillus species, which help in maintaining the normal flora of the gut and eliminating pathogenic bacteria.
  • I.V.  infusions
    In the case of extreme dehydration, your doctor will start an intravenous infusion of fluids like Ringer’s lactate solution. Hospital admissions are common in the case of infants and children as they are not able to drink sufficient water orally and show signs of dehydration early.
  • Antipyretic drugs
    In cases of heatstroke, the body temperature increases, which is can be controlled by taking antipyretic drugs like paracetamol. (Read more - Fever causes and treatment)
  • Antibiotics
    In cases where dehydration is caused by infections, an antibiotic course is the treatment of choice along with rehydration therapy.

Lifestyle modification

Lifestyle modification can help to avoid dehydration due to heat stroke, infections and insufficient water intake. Some small changes which can help prevent further dehydration are:

  • Drinking plenty of water and fluids
    Drink at least 3-4 litres of water daily to recover the water lost due to sweating. Drinking coconut water and lemonade is also beneficial.
  • Maintaining good hygiene
    The habit of washing hands every time you come home from outside, after using toilets, and before cooking or eating anything can help in preventing infections.
  • Limiting alcohol consumption
    Drinking alcohol is an important cause of dehydration. So, avoiding alcohol intake till you recover from dehydration and slowly decreasing its amount along with drinking adequate water can help prevent dehydration from recurring.

Prognosis

The outcome of dehydration is good in adults where plenty of fluids are administered, either orally or by an intravenous route. In children, prognosis depends upon the amount of fluid loss and the time of administration of the treatment. Early treatment can rapidly correct dehydration and prevent complications.

Complications

Dehydration, if not treated in time, can lead to some serious complications. These include:

  • Hypotension
    It is the decrease in blood pressure due to a reduction in the volume of blood. This can decrease the supply of oxygen to vital organs and lead to a dizziness or unconsciousness (fainting).
  • Impaired cognition
    Moderate to severe dehydration affects memory and understanding. You may feel disoriented or take some time to understand what is happening around you.
  • Organ damage and dysfunction
    Dehydration can lead to low blood volume which can affect the supply of essential nutrients and oxygen to the organs. This can cause organ damage and malfunctioning.
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