Definition

Dehydration is a medical condition in which the body loses more fluid than it takes in. If you don't consume enough fluids to meet your daily needs, you become susceptible to dehydration. Anyone can experience dehydration, but it can be especially risky for children and the elderly. Based on the symptoms, dehydration is classified as mild, moderate, or severe. Mild and moderate cases of dehydration can usually be managed independently without needing to go to the hospital.

The most common cause of dehydration in children is severe diarrhea and vomiting. In the elderly, dehydration often occurs due to inadequate fluid intake and the use of medications that can lead to excessive fluid loss. Simple illnesses such as lung or urinary tract infections can also cause adult dehydration. Dehydration is also common in hot weather, especially when engaging in physical activity.

Causes

Sometimes, dehydration results from simple events like insufficient water and increased physical activity, but it can also be due to underlying illnesses. Several causes of dehydration include:

• Gastroenteritis: This digestive tract illness is characterized by diarrhea and sometimes vomiting, leading to significant fluid loss, especially if not balanced with sufficient fluid intake.
• Fever: Elevated body temperature can lead to dehydration. Generally, the higher your body temperature, the greater the risk of dehydration.
• Excessive sweating: You can lose fluids when you sweat excessively. Intense physical activity without adequate fluid intake can lead to dehydration. Hot weather also increases the risk.
• Excessive urination: This can be caused by undiagnosed diseases or uncontrolled diabetes. Some medications, such as diuretics and certain blood pressure drugs, can also lead to dehydration due to increased urination.

Risk factor

Everyone is at risk of dehydration, but certain factors increase this risk:

• Infants and children: These age groups are at higher risk of digestive issues like diarrhea and vomiting, making them susceptible to dehydration. Their lower body surface area can lead to quicker dehydration, and fever can lead to quicker dehydration. Additionally, children often do not recognize thirst or need for sufficient water intake.
• Elderly: Older adults have a reduced sense of thirst, making them more prone to dehydration due to inadequate daily fluid intake. This issue is often compounded by chronic illnesses such as diabetes and dementia and the use of routine medications that can affect urination frequency. Reduced mobility also makes it difficult for the elderly to get water themselves.
• Chronic illnesses: Uncontrolled chronic illnesses like diabetes can increase the risk of dehydration.
• Outdoor jobs or activities: Hot and dry weather increases the risk of dehydration due to faster water evaporation.

Symptoms

Thirst is not always an indicator that your body needs fluids. Many people, especially the elderly, do not feel thirsty despite being dehydrated. Self-awareness is crucial to ensuring adequate fluid intake, particularly during outdoor activities in hot weather. Symptoms and signs of dehydration can vary by age group:

• Infants and children
• Dry mouth and tongue
• No tears when crying
• No wet diapers
• Sunken eyes and cheeks
• Sunken soft spot on top of the skull
• Irritability or lethargy
• Adults
• Excessive thirst
• Less frequent urination
• Dark-colored urine
• Fatigue
• Dizziness
• Confusion

Diagnosis

Your doctor will inquire about dehydration symptoms and medical history and perform a physical examination. Vital signs such as blood pressure, heart rate, and temperature will be checked. Low blood pressure accompanied by an increased heart rate is a critical sign indicating shock. Cold body temperature is also a sign requiring immediate attention.

To confirm the diagnosis, the doctor may conduct additional tests, such as:

• Blood tests: Blood samples will check for electrolyte imbalances, particularly sodium and potassium levels, and evaluate kidney function.
• Urine tests: These help determine the degree of dehydration and check for urinary tract infections.

Management

The only way to treat dehydration is by replacing lost fluids and electrolytes. Treatment depends on the severity, age, and cause of the dehydration. For infants and children dehydrated due to diarrhea, vomiting, or fever, use an oral rehydration solution (ORS) to replace lost fluids and electrolytes. Start with 1 teaspoon every 1 to 5 minutes. Using a syringe is helpful for very young babies. For adults with mild to moderate dehydration from diarrhea, vomiting, or fever, drink water or other fluids such as fruit juice. For severe dehydration with confusion or decreased consciousness, seek immediate medical attention for intravenous fluids.

Complications

Ignoring dehydration can lead to serious complications, such as:

• Heat exhaustion: Without sufficient fluid intake during intense exercise and excessive sweating, you can suffer from heat injury, which includes symptoms like muscle cramps, excessive fatigue, headaches, and can escalate to heat stroke, a life-threatening condition.
• Urinary and kidney problems: Recurrent and prolonged dehydration can cause urinary tract infections, kidney stones, and even kidney failure due to cell damage and reduced filtration function.
• Electrolyte imbalance: Sodium and potassium are vital for transmitting signals between cells. An imbalance can disrupt electrical stability in the body, leading to involuntary muscle movements and potential loss of consciousness.
• Shock: This life-threatening condition occurs due to a lack of oxygen delivery throughout the body. During shock, blood pressure drops drastically, preventing adequate blood circulation.

Prevention

Drinking sufficient water and consuming fruits and vegetables rich in fluids is advisable to prevent dehydration. Do not let yourself feel thirsty for too long.

Certain individuals may require more fluids under specific conditions, such as:

• Vomiting and diarrhea: If your child is vomiting or has diarrhea, start giving them plenty of water or oral rehydration solutions without waiting for dehydration symptoms to appear.
• Intense physical activity: Drinking water before intense exercise is a good step to prevent dehydration. Urine color is an indicator of the body's hydration status. Replace lost fluids regularly.
• Elderly with or without a history of illness: Monitor fluid intake in older adults and remind them to drink fluids regularly. Uncontrolled diabetes often leads to severe dehydration.

When to see a doctor?

For mild to moderate diarrhea, you can usually manage it by drinking sufficient fluids, but if you notice the following signs or symptoms, seek medical attention immediately:

• Severe diarrhea lasting more than a day
• Altered consciousness or irritability in children
• Excessive sleeping and reduced activity compared to usual
• Decreased urination frequency and amount

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