Stay fluid

Avoid dehydration

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Winnipeg Health Region
Wave, July / August 2012

Why is it important to stay hydrated?

The human body needs water to maintain normal functions. The liquid and chemicals (salts and minerals) within the body are normally maintained in correct balance because the body adjusts the amount of liquid taken in and the amount of liquid lost by regulating thirst and elimination processes. When not enough fluids are taken by mouth, the body adapts by taking fluids from the tissues, muscles and organs.

If your body loses much more fluid than you are drinking, you become dehydrated. When you are dehydrated, you have a smaller volume of blood circulating through your body, consequently, the amount of blood your heart pumps with each beat decreases. If the loss of fluid is severe, you can become very ill. Therefore, it is important for everyone to ensure they are properly hydrated by drinking enough fluids during the day to maintain good health.

I can see how dehydration might be a problem in a hot weather climate, but is it a serious issue in Manitoba?

During the summer months, when temperatures are higher than normal and/ or humidity levels are higher than normal, the risk for negative health effects is as high as in hot weather climates. Every year over 300 Manitobans are admitted to hospital due to dehydration.

What are the symptoms of early or mild dehydration?

Symptoms of early or mild dehydration include:

  • Thirst
  • Flushed face
  • Dry, warm skin
  • Small amounts of dark, yellow urine
  • Lightheadedness or dizziness (made worse when you stand)
  • Weakness
  • Cramping in the arms and legs
  • Having few or no tears
  • Headache
  • A lack of energy
  • Dry mouth and tongue with thick saliva
  • Decreased urine output

Call your health-care provider if you or your child experience early or mild symptoms of dehydration and you have concerns or questions.

When dehydration is moderate to severe, other symptoms are no urine output for eight hours or more, and any of the following symptoms:

  • Low blood pressure
  • Fainting
  • Severe muscle contractions in the arms, legs, stomach, and back
  • Convulsions
  • A bloated stomach
  • Sunken eyes with few or no tears
  • Sunken soft spot (for infants)
  • Lack of skin elasticity (a bit of skin lifted up takes a long time to go back to its normal position)
  • Rapid and deep breathing
  • Increased heart rate

Moderate to severe symptoms of dehydration can be serious and need medical attention. Go to the emergency department.

What causes dehydration?

Other than simply not drinking enough water, other causes of dehydration include:

  • Diarrhea and vomiting
  • Not eating or drinking enough during an illness
  • Medicines that control excess body fluid (diuretics, or "water pills") by causing fluid loss are a common longterm cause
  • Uncontrolled diabetes

Although anyone can become dehydrated, people who become dehydrated the most easily are:

  • Babies less than one year old
  • Older adults
  • Anyone who has a fever
  • People in hot weather
  • People with diabetes if they are urinating a lot because their blood sugar is too high
  • People doing strenuous work or activity, especially in the heat

How is dehydration treated?

If you are mildly dehydrated, you need to drink enough liquid to replace the fluids you have lost. Also, you need to replace the electrolytes you have lost. Drinking sips of fluids slowly, along with eating the typical diet, which is high in salt, will replace fluids and salts. You can replace fluids and electrolytes by drinking sports drinks or other oral rehydration solutions (ORS). Drink the solution right away. Do not wait until dehydration becomes severe.

For infants and small children, if parents cannot obtain regular ORS (Pedialyte is one brand name), consider a homemade ORS. Mix 1/2 cup of dry infant rice cereal with two cups of water and 1/4 teaspoon of salt. Give small amounts frequently - one teaspoon every five minutes. For large children and adults, if you don't have a sports drink or ORS, you can make an oral rehydration solution using the following recipe: To one litre of drinking water or boiled water, add the following:

  • Two tablespoons sugar
  • 1/2 teaspoon salt

If possible, add 1/2 cup orange juice or some mashed banana to improve the taste and provide some potassium. Drink sips of the ORS every five minutes until urination becomes normal. Adults and large children should drink at least three litres of ORS a day until they are well. If you are vomiting, keep trying to drink the ORS. Your body will retain some of the fluids and salts you need even though you are vomiting. Remember to take only sips of liquids. Chilling the ORS may help. If you have diarrhea, keep drinking the ORS. The fluids will not increase the diarrhea.

Is dehydration a serious issue for seniors?

Yes. A lack of fluids can be a serious problem for older adults. As you get older, your body's warning signals get weaker. People over the age of 50 need to drink fluids even when they are not thirsty. This is particularly important if you have retired to an area of the country that is warmer than you are used to.

How much water should a person drink to avoid dehydration?

That depends on the circumstances. A person playing a lot of tennis on a hot day will need more than someone who is working inside an air-conditioned office. The amount of fluid that a person needs to drink every day is different for everyone. Your fluid intake can include water as well as a variety of other fluids. To determine whether you are drinking enough water you should:

Check your thirst - if you are thirsty or have a dry mouth, it is likely that you are not drinking enough.

Check your urine - if your urine is dark yellow and has a strong smell, you may not be getting enough fluids. Also, check the amount of urine. It is normal to void four to five times a day.

Check your mood - if you feel lightheaded and tired, are not able to focus or have many headaches, these could be signs that you are dehydrated. Adequate fluid consumption depends on:

  • Your age and body size
  • What you eat (various foods contain different amounts of water)
  • Your level of activity (the more active you are, the more water you need)
  • The weather (the warmer the weather, the more water you need)
  • Your health
  • Whether you are a man or woman (men usually need more water than women do because they have more lean muscle)
  • What medicines you take (some medicines cause your body to lose water, such as diuretics).

Most of the time you will get enough fluid if you:

  • Eat a healthy diet
  • Drink fluids with each meal
  • Drink fluids between meals

Drink more fluid during:

  • Strenuous exercise (drink 4 to 6 ounces of water for every 15 minutes of exercise)
  • Hot weather to avoid heat stroke or heat exhaustion

If you are taking certain medicines or if you have a chronic disease, such as congestive heart failure or kidney problems, you may need to drink more or less water. Talk with your health-care provider about how much fluid you should drink every day.

Can any kind of fluid keep you hydrated?

Water is the best fluid to drink because it contains no calories or chemicals that might affect fluid balance in the body. Here are some tips to get more fluids in your diet:

  • Avoid coffee, tea, and sodas with caffeine
  • Drink more fluids whenever you are vomiting or have diarrhea
  • Drink plenty of extra fluids after even mild exercise
  • Have more soups with your meals
  • Keep a glass of water to drink while you are watching TV or relaxing
  • Learn about medicines you are taking that might cause water loss
  • Limit alcohol to no more than one drink per day for women and no more than two drinks per day for men

Use caution and check with your healthcare provider about drinking sports fluids when your diet is restricted or when you are taking prescription medicines.

Audra Kolesar is a registered nurse and manager with Health Links - Info Santé, the Winnipeg Health Region's telephone health information service.

The information for this column is provided by Health Links - Info Santé. It is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health-care professional. You can access health information from a registered nurse 24 hours a day, seven days a week by calling Health Links - Info Santé. Call 788-8200 or toll-free 1-888-315-9257.

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