Dehydration

Definition

Dehydration occurs when you lose more fluid than you take in, and your body doesn't have enough water and other fluids to carry out its normal functions. If you don't replenish lost fluids, you may suffer serious consequences.

Common causes of dehydration include intense diarrhea, vomiting, fever or excessive sweating. Inadequate intake of water during hot weather or exercise also may cause dehydration. Anyone may become dehydrated, but young children, older adults and people with chronic illnesses are most at risk.

You can usually reverse mild to moderate dehydration by increasing your intake of fluids, but severe dehydration needs immediate medical treatment. The safest approach is prevention of dehydration. Monitor your fluid loss during hot weather, illness or exercise, and drink enough liquids to replace what you lose.

Symptoms

Mild to moderate dehydration is likely to cause:

• Dry, sticky mouth
• Sleepiness or tiredness — children are likely to be less active than usual
• Thirst
• Decreased urine output — fewer than six wet diapers a day for infants and eight hours or more without urination for older children and teens
• Few or no tears when crying
• Muscle weakness
• Headache
• Dizziness or lightheadedness

Severe dehydration, a medical emergency, can cause:

• Extreme thirst
• Extreme fussiness or sleepiness in infants and children; irritability and confusion in adults
• Very dry mouth, skin and mucous membranes
• Lack of sweating
• Little or no urination — any urine that is produced will be dark yellow or amber
• Sunken eyes
• Shriveled and dry skin that lacks elasticity and doesn't "bounce back" when pinched into a fold
• In infants, sunken fontanels — the soft spots on the top of a baby's head
• Low blood pressure
• Rapid heartbeat
• Fever
• In the most serious cases, delirium or unconsciousness

Unfortunately, thirst isn't always a reliable gauge of the body's need for water, especially in children and older adults. A better barometer is the color of your urine: Clear or light-colored urine means you're well hydrated, whereas a dark yellow or amber color usually signals dehydration.

When to see a doctor
If you're a healthy adult, you can usually treat mild to moderate dehydration by drinking more fluids. Get immediate medical care if you develop severe signs and symptoms such as extreme thirst, no urination for eight hours, shriveled skin, dizziness and confusion.

Treat children and older adults with greater caution. Call your family doctor right away if your child:

• Develops severe diarrhea, with or without vomiting or fever
• Has had episodes of vomiting for more than eight hours
• Has had moderate diarrhea for three days or more
• Can't keep down fluids
• Is irritable or disoriented and much sleepier or less active than usual
• Has any of the signs or symptoms of mild or moderate dehydration

Go to the nearest hospital emergency room or call 911 or your emergency medical number if you think a child or older adult is severely dehydrated. You can help prevent dehydration from becoming severe by carefully monitoring someone who is sick and giving fluids at the first sign of diarrhea, vomiting or fever and by encouraging children to drink plenty of water before, during and after exercise.

Causes

Water is essential to human life: It forms the basis for all body fluids, including blood and digestive juices; it aids in the transportation and absorption of nutrients; and it helps eliminate waste.

If you're an average adult, every day you lose more than 10 cups (close to 2.5 liters) of water simply by sweating, breathing and eliminating waste. You also lose electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body. Normally, you can replenish what you've lost through the foods and liquids you consume, even when you're active.

But when you eliminate more water and salts than you replace, dehydration results — your system literally dries out. Sometimes dehydration occurs for simple reasons: You don't drink enough because you're sick or busy, or because you lack access to potable water when you're traveling, hiking or camping.

Other dehydration causes include:

• Diarrhea, vomiting. Severe, acute diarrhea — that is, diarrhea that comes on suddenly and violently — can cause a tremendous loss of water and electrolytes in a short amount of time. If you have vomiting along with diarrhea, you lose even more fluids and minerals. Children and infants are especially at risk. Dehydration is a leading cause of death in children worldwide. In the United States, up to 300 children die of dehydration each year.
• Fever. In general, the higher your fever, the more dehydrated you may become. If you have a fever in addition to diarrhea and vomiting, you lose even more fluids.
• Excessive sweating. You lose water when you sweat. If you engage in vigorous activity and don't replace fluids as you go along, you can become dehydrated. Hot, humid weather increases the amount you sweat and the amount of fluid you lose. But you can also become dehydrated in winter if you don't replace lost fluids. Preteens and teens who participate in sports may be especially susceptible, both because of their body weight, which is generally lower than that of adults, and because they may not be experienced enough to know the warning signs of dehydration.
• Increased urination. This is most often the result of undiagnosed or uncontrolled diabetes mellitus, a disease that affects the way your body uses blood sugar and that often causes increased thirst and more frequent urination. Another type of diabetes, diabetes insipidus, also is characterized by excessive thirst and urination, but in this case the cause is a hormonal disorder that makes your kidneys unable to conserve water. Certain medications — diuretics, antihistamines, blood pressure medications and some psychiatric drugs — as well as alcohol also can lead to dehydration, generally because they cause you to urinate or perspire more than normal.
• Burns. Doctors classify burns according to the depth of the injury and the extent of tissue damage. Third-degree burns are the most severe, penetrating all three layers of skin, and often destroying sweat glands, hair follicles and nerve endings. People with third-degree burns or extensive first- or second-degree burns experience profound fluid loss, and the resulting dehydration can be life-threatening.