The term dehydration is defined as a condition that can occur due to loss of body fluids, usually water, exceeds the amount that is taken in. In dehydration, more fluid is moving out of individual cells and then out of the body than the amount of fluid that is taken in through drinking.
Medically, dehydration means a person has lost enough fluid resulting inability to fu-nction normally and begins to produce symptoms of fluid loss. Dehydration of skin and mucous membranes is called medical dryness. Water is loosed everyday in the form of water vapour:
• Through exhaled breath
• Through sweating
• Through urine and
• Through stool.
Small amount of electrolytes (salts) are also lost with water. Our body regularly adjust water and electrolyte balance with fluid intake. In case when too much water is lost this balance is disturbed causing dehydration.
Stages (Types) of dehydration :
Mostly dehydration is categorised in three stages by doctors:
1. Mild dehydration
2. Moderate dehydration
3. Severe dehydration
When dehydration is severe, is a life threatening emergency which need quick medical aid.
Causes of dehydration :
• There are so many conditions which may cause rapid and continuous fluid loss, leads to dehydration.
• Too much exercise, fever, and heat exposure.
• Diarrhoea and vomiting
• Increased urination in uncontrolled and use of diuretic.
• Excessive loss of fluid, not drinking enough water or fluid or both.
• In case of illness in children, dehydration often occurs due to lack to eat or drink any thing and losing fluid from vomiting, diarrhoea or fever.
• Infants and children are more likely to become dehydrated than adults because their body looses water and electrolytes more quickly.
• Elderly person with long illness are also at high risk.
• Severe skin injuries like burns, severe skin diseases or infections, water is lost through the damaged skin.
• Dehydration may occur in following conditions such as nausea, illness induced loss of appetite and sore throat/ mouth sore.
Signs and Symptoms of dehydration :
Signs and symptoms of dehydration in adults may ranges from mild to severe. Mild to Moderate dehydration may include following:
• Increased thirst
• Dry or sticky mouth
• Sleepy and tired
• Decreased urine output. Urine volume is low and dark colour. No urine in case of severe dehydration
• Irritability is often marked
• Dry eyes with lack of tears or no tears when crying
• Palpitations (rapid heart rate)
• Poor skin elasticity i.e. abdominal skin slowly sinks back to its normal position when pinched
• Dizziness when standing due to postural hypotension
• Insomnia in some cases may be observed
Other possible symptoms may include are :
• Cloudy urine with stinging sensation
• Blood may show hyper albuminemia may associated with confusion, fatigue and negative moods.
In case of moderate to severe dehydration all the above signs and symptoms worsen quickly with following:
• Too much decreased urine output or no urine output
• If any urine produced, is concentrated, dark yellow or amber coloured
• Headaches are similar to that of hangover headache
• Sunken fontanel (soft spot) in infants
• Sunken eyes
• Sudden visual snow
• Low blood pressure (hypotension)
• Dizziness (a feeling that you are about to fall)
• Postural hypotension (low blood pressure when standing)
Untreated dehydration may lead to :
• Swelling of tongue and
When you seek medical advice :
Call your physician when dehydrated person develop any of the following symptoms-
• Regular or increased vomiting more than 24 hours.
• Fever more than 101 degree F
• Decreased urine production
• Diarrhoea more than 2 days
• Regular weight loss
• State of confusion
Patient must be hospitalised in following conditions :
• Fever more than 103 degree F
• Patient in state of confusion
• Weakness or state of lethargy
• Chest/ abdominal pain
• Difficulty in breathing
• Seizures (fits)
• No urine output since last 12 hours
Treatment of dehydration :
• Treatment of mild grade of dehydration quit effective by drinking water and stopping fluid loss.
• Plain water restores only blood plasma volume and not the electrolyte imbalance.
• To maintain proper fluid and electrolyte balance ORS (oral rehydration salt) is given.
• In infants and children, avoid plane water as a primary replacement fluid.
• Sugar /glucose can cause or worsen the diarrhoea.
• Solid foods can cause fluid loss from diarrhoea and vomiting.
• In moderate to severe cases dehydration can be corrected by water and electro-lytes through oral rehydration therapy or fluid & electrolytes by intravenous infusion.
• Oral rehydration therapy is painless, non-invasive, less expensive and easier to provide, it is treatment of choice for mild to moderate grade of dehydration.
• In case with severe dehydration symptoms patient must be hospitalized in intensive care unit and treated accordingly.
Differential diagnosis of dehydration :
1. External or Stress related causes
2. Infectious diseases
4. Other causes of obligate water loss
Prevention of dehydration :
• Drink plenty of water and fluids everyday
• Drink more fluid in hot weather or you are exercising
• Monitor infants, children and older adults when they are fall sick
• If you think that a person is getting dehydrated, call your doctor before the person becomes dehydrated.
• Fluid and electrolyte balance is maintained by intra venous infusion as soon as diarrhoea and vomiting start.
• DO-NOT wait for signs of dehydrations.
• Encourage patient to drink fluids.
• Fluid intake must be increased in case of fever, diarrhoea or vomiting.
Signs to monitor in case of dehydration are:
• Urine output can be judged by frequent wet diapers or trips to the bathroom.
• Saliva in mouth and
• Tears when crying
Complications of dehydration:
Untreated severe dehydration may lead to:
• Irreversible brain damage
• Seizures / Fits
Prognosis of dehydration:
Expectations or prognosis of dehydration depends upon the early diagnosis and quick treatment. If patient is treated well in time, prognosis is usually good.