Stay hydrated and learn about dehydration's symptoms, causes, effects, and treatment options. Recognize the signs of dehydration and stay healthy with Meri Sehat.

Dehydration

Humza Khizer

Overview

Dehydration is when your body loses more fluid than it takes in. Ultimately, it does not have enough fluid to function properly. 
&nbsp;

Your body is 55-78% water. Babies and young children have comparatively more water (as a percentage of body weight) than adults. Besides age, the percentage of water varies due to body type because some people, women especially, have more fatty tissue that contains less water than lean tissue. 
&nbsp;

Water makes up roughly 78% of a healthy newborn&rsquo;s body; in a 1-year-old, it constitutes 65%, while in an adult man and adult woman, the amount is 60% and 55% respectively<a href="#accordion">[1]</a>. 
&nbsp;

Where is this water stored?

<ul>
	<li>90% &ndash; Plasma</li>
	<li>83% &ndash; Lungs</li>
	<li>79% &ndash; Kidneys</li>
	<li>79% &ndash; Muscles</li>
	<li>73% &ndash; Brain</li>
	<li>73% &ndash; Heart</li>
	<li>64% &ndash; Skin</li>
	<li>31% &ndash; Bones 
	&nbsp;</li>
</ul>

In short, your body needs water to aid digestion, remove wastes, lubricate your joints, produce saliva, create neurotransmitters and hormones to balance the body&rsquo;s chemicals, deliver oxygen, cushion your bones, and regulate your body temperature<a href="#accordion">[1]</a>. 
&nbsp;

That&rsquo;s a lot of work that requires &ndash; and uses &ndash; the body&rsquo;s composition of water. So, what happens when there&rsquo;s excessive fluid loss from the body or when your body &ldquo;dehydrates?&rdquo;

Dehydration occurs when your body lacks the necessary fluids to function properly. It occurs when the water loss is greater than the water replaced. 
&nbsp;

The World Health Organization defined extreme dehydration as a loss of more than 10% of body weight in liquids. It can be mild, moderate, or severe based on how much body fluid is lost. You are already mildly dehydrated if you feel&nbsp;thirsty, which can result in symptoms, including headache, weariness, and dizziness. Dehydration can lead to life-threatening conditions, like heatstroke. 
&nbsp;

Drinking before you become thirsty is the best defense against dehydration. Every day, your body loses water by breathing, sweating, urinating, passing stool, menstruating as well as tears and saliva (spit). Typically, you restore the lost liquid by consuming liquids and foods that are high in water content, but severe dehydration requires rapid medical attention.&nbsp; 
&nbsp;

Older people are 20-30% more likely to become dehydrated as a result of immobility, renal disease,&nbsp;a compromised thirst mechanism, <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">diabetes</a>,&nbsp;and falls<a href="#accordion">[2]</a>. 
&nbsp;
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There are 3 types of dehydration<a href="#accordion">[2]</a>:

<ul>
	<li>Isotonic Dehydration: When sodium and water are lost together. Examples are vomiting, sweating, and diarrhea.</li>
	<li>Hypertonic Dehydration: when you lose more water than sodium. Examples are fever, diabetes insipidus, and increased respiration.</li>
	<li>Hypotonic Dehydration: When you lose more sodium than water. An example is diuretics or water pills that clear extra fluid in the body and lower high blood pressure. 
	&nbsp;</li>
</ul>

Based on the severity, there are 3 levels of dehydration<a href="#accordion">[1]</a>:

<ul>
	<li>Mild: Where you lose fluid through vomiting, sweating, and diarrhea, but it is easily treated with an oral intake of fluids. You feel better 5-10 minutes after treatment.</li>
	<li>Moderate: An IV hydration is required in this case. This is usually dealt with by professionals in a hospital&rsquo;s emergency.</li>
	<li>Severe: If dehydration symptoms are severe, please see a healthcare provider immediately. 
	&nbsp;</li>
</ul>
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Signs and Symptoms

The body doesn&#39;t always use thirst as a dependable early indicator of its water demand. Many people, especially elders, don&#39;t become thirsty until they are already dehydrated. This is why it&#39;s crucial to drink more water when it&#39;s hot outside or when you&#39;re sick. 
&nbsp;

To be able identify dehydration, it&rsquo;s also important to identify what constitutes no dehydration<a href="#accordion">[11]</a>:

<ul>
	<li>Normal thirst</li>
	<li>Awake and alert</li>
	<li>Eyes that don&rsquo;t appear sunken</li>
	<li>Normal pulse</li>
	<li>Skin pinch goes back normally 
	&nbsp;</li>
</ul>

Signs and symptoms of dehydration in infants are:

<ul>
	<li>No wet nappy for at least 3 hours</li>
	<li>Dark urine</li>
	<li>Sunken eyes and cheeks</li>
	<li>Dry tongue and mouth</li>
	<li>Sunken soft spot at the top of the skull</li>
	<li>No tears or fewer tears are produced when they cry</li>
	<li>Cold hands and feet</li>
	<li>Irritability or lethargy</li>
	<li>Fast breathing 
	&nbsp;</li>
</ul>

Signs and symptoms of mild or moderate dehydration in adults:

<ul>
	<li>Thirst</li>
	<li>Reduction in the frequency of urination</li>
	<li>Dark yellow urine</li>
	<li>Sticky or dry mouth</li>
	<li>Cool or dry skin</li>
	<li>Muscle cramps</li>
	<li>Headache </li>
	<li>Skin with poor turgor, i.e., it takes time to return to its normal position when it&rsquo;s pinched</li>
	<li>Bad breath due to less production of saliva 
	&nbsp;</li>
</ul>

Signs and symptoms of severe dehydration in adults include symptoms of mild hydration as well as the following:

<ul>
	<li>Excessive thirst</li>
	<li>Really dry and shriveled skin</li>
	<li>Lack of sweat production</li>
	<li>Vertigo </li>
	<li>Delirium </li>
	<li>Fast heart rate</li>
	<li>Fast breathing</li>
	<li>Sunken eyes</li>
	<li>Irritability, confusion, drowsiness, and lethargy</li>
	<li>When the skin is pinched, it goes back very slowly</li>
	<li>Low blood pressure</li>
	<li>Fever</li>
	<li>Dark urine</li>
	<li>Fainting </li>
</ul>

Note: Severe dehydration can lead to complications if it&rsquo;s left untreated. If you face any of the above symptoms of severe dehydration, it is imperative that you seek emergency medical care<a href="#accordion">[3][4]</a>. 
&nbsp;

Causes

Dehydration can be caused by not consuming enough water, losing too much water, or a combination of both. Sometimes it&#39;s difficult to drink enough water because we&#39;re too busy. Sometimes, we require some sort of assistance due to disability, old age, and lack of resources or energy. Sometimes, it&rsquo;s simply because we&rsquo;re in a region without access to potable water (for example, while hiking or camping). 
&nbsp;

Other reasons for dehydration include:

<ul>
	<li>Diarrhea &ndash; This is the main reason for deaths connected to dehydration. Diarrhea stops the big intestine from absorbing water from food and, at the same time, the body continues to excrete too much water. 
	&nbsp;</li>
	<li>Vomiting &ndash; This results in a loss of fluids, making it difficult to replace the fluid lost by consuming water as it doesn&rsquo;t stay in. 
	&nbsp;</li>
	<li>Sweating &ndash; Sweating is your body&rsquo;s cooling mechanism. Fever, hot weather, and strenuous physical activity further increase loss of water. . It&rsquo;s usually accompanied by diarrhea or vomiting that further depletes the body of water and electrolytes. 
	&nbsp;</li>
	<li>Diabetes &ndash; It increases urination, resulting in fluid loss. 
	&nbsp;</li>
	<li>Frequent Urination &ndash; Uncontrolled diabetes often leads to frequent urination. However, there can be other reasons, too, including alcohol and medicines, such as antihistamines, diuretics, antipsychotics, and blood pressure medication. 
	&nbsp;</li>
	<li>Burns &ndash; When blood arteries are injured, it can cause fluid to leak into the nearby tissues. 
	&nbsp;</li>
	<li>Sun &ndash; Too much sun exposure depletes body fluids and essential body salts, like potassium and sodium, and can in some cases lead to heatstroke. 
	&nbsp;</li>
	<li>Diuretics &ndash; These medications deplete electrolytes along with body fluids. They can occasionally cause dehydration. 
	&nbsp;</li>
</ul>

Seek Immediate Medical Care If You Have:

<ul>
	<li>Blood in stool</li>
	<li>Diarrhea for 3 or more days</li>
	<li>The inability to keep fluids in your system</li>
	<li>Disorientation</li>
	<li>Absent or weak pulse</li>
	<li>Respiratory distress<a href="#accordion">[6][8]</a> 
	&nbsp;</li>
</ul>
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Diagnosis

If you feel thirsty, you are already dehydrated, so that is one way to diagnose mild dehydration.

The doctor will first take your medical history to rule out other health problems. They will also check for physical signs and symptoms of dehydration. Tachycardia, fever, muscle cramps, decreased or dark urine, palpitations, and orthostatic hypotension, are all telltales of dehydration. A physical exam may also reveal the following in a dehydrated patient<a href="#accordion">[2]</a>: 
&nbsp;

<ul>
	<li>A weight loss of at least 3% over 7 days may also be a sign of dehydration</li>
	<li>fatigue</li>
	<li>Dry or cracked lips and skin</li>
	<li>Dry mucosa,</li>
	<li>Delayed capillary refill</li>
	<li>Skin tenting 
	&nbsp;</li>
</ul>

The blood tests and urinalysis used to diagnose and confirm the degree of dehydration are:

<ul>
	<li>Creatinine test to assess kidney function</li>
	<li>Blood urea nitrogen test to assess kidney function</li>
	<li>Serum osmolality test to measure the balance between certain chemicals and water in the blood.</li>
	<li>Urine sodium test to check the amount of sodium in a urine sample</li>
	<li>Ultrasound to assess fluid volume</li>
</ul>

NOTE: The symptoms often resemble other medical problems. Therefore, it&rsquo;s always better to consult a doctor for a proper diagnosis<a href="#accordion">[1]</a>. 
&nbsp;

Treatment

Treatment depends on how severe the condition is. For instance, children who have mild dehydration can be given extra liquids at home only under doctor&rsquo;s guidance. A severe case of dehydration will, of course, need treatment at the ER. 
&nbsp;

<ul>
	<li>If you are dehydrated, but can sit up and drink, you should immediately drink an oral rehydration solution (ORS). If ORS is unavailable, drink water, broth, or any other fluids you can. Remember, the purpose here is to rehydrate your body. Avoid soft drinks and other high sugar content drinks that can worsen your condition. </li>
</ul>

For older children and adults, the recommended amount is 100 ml of ORS every 5 minutes until the patient stabilizes. You can determine the required amount of ORS (in milliliters) during 4 hours by multiplying your weight in kg by 75<a href="#accordion">[11]</a>. 
&nbsp;

<ul>
	<li>If you have to spend a lot of time outdoors and/or if it&rsquo;s a hot day, make sure you drink enough if not more water or diluted solution throughout the day. Make sure you drink at mealtimes. You can also consume food with high water content, like melon. 
	&nbsp;</li>
	<li>Stop or limit your consumption of caffeinated drinks, like tea, coffee, and soda. 
	&nbsp;</li>
	<li>Treat the underlying cause. For example, antidiarrheals for diarrhea, antiemetics for vomiting, and antipyretics for fever. 
	&nbsp;</li>
	<li>
	If the dehydration is severe, treatment by emergency personnel at the hospital or ambulance includes IV fluids, such as lactated Ringer&rsquo;s solution, dextrose solution, or saline, to help replenish the lost water and salts. 
	&nbsp;
	</li>
</ul>

<h5>Mild Dehydration In Infants And Children<a href="#accordion">[3][7]</a>.</h5>

<ul>
	<li>Use an over-the-counter oral rehydration solution for infants and kids who have been dehydrated due to diarrhea, vomiting, or fever. These solutions restore fluids and electrolytes by combining water and salt in specific ratios.</li>
</ul>

Start with roughly 1-2 teaspoons or 5-10 milliliters every few minutes. Gradually increase the quantity with increasing tolerance. For infants, you can use a syringe. For older kids, you can dilute sports drinks &ndash; 1 part water can be mixed with 1 part sports drink. 

<ul>
	<li>Babies can continue to nurse or consume formula as long as they are not frequently throwing up. 
	&nbsp;</li>
	<li>Unless a doctor recommends a change, it&rsquo;s ok if the child gets to eat their regular diet. Moreover, as long as the child is drinking enough fluids, then it does not matter if they are being fussy with food. 
	&nbsp;</li>
	<li>Sports drinks, soda, and undiluted juice should be avoided. They contain an excessive amount of sugar, which&nbsp; can worsen symptoms. 
	&nbsp;</li>
</ul>

<h5>Call Your Doctor </h5>

Contact a doctor or emergency service if the child:

<ul>
	<li>Is not drinking anything since a few hours </li>
	<li>Is 1 year old or younger and is not consuming breast milk or formula and only taking oral rehydration solution since 24 hours</li>
	<li>Has vomited multiple times in the past 24 hours</li>
	<li>Has vomit that&rsquo;s green, red, or brown colored </li>
	<li>Has not eaten anything food for 3-4 days</li>
	<li>Has all the typical symptoms of dehydration</li>
	<li>Does not seem to be improving 
	 
	NOTE: Take to the ER immediately if your child is drowsy or has stopped responding. 
	&nbsp;</li>
</ul>

<h5>Homemade Solution For Rehydration</h5>

In case of the unavailability of an electrolyte drink you can make it at home using:

<ul>
	<li>1/2 teaspoon salt</li>
	<li>6 teaspoons sugar</li>
	<li>1 liter water 
	&nbsp;</li>
</ul>

Be careful not to use more than the suggested amounts of salt and sugar. 
&nbsp;

<h5>Guidance Of Fluid Intake For Children<a href="#accordion">[9]</a></h5>

The amount of water intake depends on the weight of the child:

<ul>
	<li>0-10 kg &ndash; 100 ml/kg per day (Example: 400 ml/day if the child weighs 4 kg)</li>
	<li>10-20 kg &ndash; 1000 ml per day plus 50 ml/kg for each kilogram more than 10 kg (Example: 1200 ml/day if the child weighs 14 kg)</li>
	<li>20 kg and more &ndash;1500 ml along with 20 ml/kg over 20 kg (Example:1580 ml/day if the child weighs 24 kg) 
	&nbsp;</li>
</ul>

If dehydration is not treated, it could lead to the following complications:

<ul>
	<li>Seizures due to an electrolyte imbalance</li>
	<li>Heat Injury ranging from mild cramps, heat exhaustion, and heat stroke</li>
	<li>Reduced Blood Volume, which reduces the oxygen reaching the tissues and can result in cardiac arrhythmia, seizures, or hypovolemic shock.</li>
	<li>Kidney Issues, including kidney stones, urinary tract infections, and ultimately renal failure<a href="#accordion">[6]</a>. 
	&nbsp;</li>
</ul>

People who are at a higher risk of dehydration are:

<ul>
	<li>People suffering from a sore throat or cold as they may not want to drink or eat.</li>
	<li>Elders do not often realize they are thirsty or may not be fit enough to move around and get it themselves.</li>
	<li>People who are very active outdoors in humid or hot conditions and cannot cool down properly. This increases the body temperature and the need for more water intake.</li>
	<li>Chronic illnesses, like type 1 or 2 diabetes, can cause a person to urinate frequently if the disease is not controlled well.</li>
	<li>Young children and babies are capable of losing the most water through severe diarrhea and vomiting. They cannot inform you that they are thirsty, and neither can they get their water<a href="#accordion">[4]</a>. 
	&nbsp;</li>
</ul>

<ul>
	<li>Ask your doctor or other health care professional how much liquid you should consume daily because everyone&#39;s needs are different.</li>
	<li>The recommended total daily fluid consumption for women is 2,200 ml and, for males, it&rsquo;s 3,000 ml<a href="#accordion">[10]</a>.</li>
	<li>Sports drinks can be beneficial if you are exercising in the heat and sweating a lot.</li>
	<li>Avoid beverages with caffeine and sugar.</li>
	<li>Always drink more fluids when it&#39;s hot outside or you&#39;re feeling under the weather. Make a conscious effort for your health. If you forget, keep reminders on your phone or a drinking buddy who can remind you to keep hydrated throughout the day<a href="#accordion">[5]</a>. 
	&nbsp;</li>
</ul>
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Key Points

<ul>
	<li>Dehydration is when your body loses more fluid than it takes in. Ultimately, it does not have enough fluid to function properly. </li>
	<li>You are already mildly dehydrated if you feel&nbsp;thirsty. Symptoms of dehydration include but are not limited to&nbsp; headache, weariness, and dizziness. Dehydration can lead to life-threatening conditions, like heatstroke.</li>
	<li>Many people, especially elders, don&#39;t become thirsty until they are already dehydrated. Because of this, it&#39;s crucial to drink more water when it&#39;s hot outside or when you&#39;re sick.</li>
	<li>The doctor checks for physical signs and symptoms of dehydration. Weight loss of at least 3% over 7 days can also be a sign of dehydration.</li>
	<li>Rehydrating techniques, electrolyte replacement, and, if necessary, managing diarrhea or vomiting are all treatments for dehydration.</li>
	<li>Use an over-the-counter oral rehydration solution for infants and kids who have been dehydrated due to diarrhea, vomiting, or fever. These solutions restore fluids and electrolytes by combining water and salt in specific ratios.</li>
	<li>Severe dehydration can lead to complications if left untreated. In case of severe dehydration, it is imperative that you seek emergency medical care. 
	&nbsp;</li>
</ul>
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