Our bodies are made up of 50% to 80% water, depending on our age. With age, our total body content of water naturally decreases, which makes the elderly population prone to dehydration, that can occur when we lose too much of that water either from sweating, vomiting or diarrhea, among other causes.
There are three different stages of dehydration: mild, moderate and severe. With mild dehydration, most people say they feel “funny” or they just don’t feel like themselves. At this stage, drinking more water can make you feel better.
Without intervention, the state of dehydration progresses to the moderate stage of dehydration. At this stage, we start to develop more prominent symptoms such as severe thirst, dry eyes/mouth, and even lightheadedness or confusion can develop. These are significant symptoms that we need to take into consideration and not ignore. If you don’t seek medical care at this point, we move into the severe category, which can lead to more severe mental status changes, such as lethargy, obtundation, and even loss of consciousness. It can be life threatening if it isn’t addressed at this point.
There are multiple reasons that can lead to dehydration, but the most common are when people can’t keep fluids in their body due to vomiting and/or diarrhea. If you are able to drink water or fluids, but it’s coming out too quickly before your intestines can absorb it, which is the case with diarrhea, or you are not able to tolerate any fluids, which is the case with vomiting, these will cause a drop in your body’s total water content.
Another common cause can be excessive sweating, such as due to fever or heat exposure. In some situations, despite maintaining adequate fluid intake, a large amount of our body’s water content can be lost via sweat. This can also lead to dehydration and the symptoms listed above caused by dehydration. For this reason, it is important to take breaks from excessive heat when performing activities in extremely hot conditions, such as gardening/yardwork on a really hot day.
Also, fevers can lead to dehydration because the body’s response to a fever is to cool itself down. It does this by the evaporation process of sweat. During severe episodes of sweating due to high fevers, dehydration can occur.
Some blood pressure medications called diuretics can also lead to dehydration when a primary risk factor for dehydration is present, such as nausea, vomiting, diarrhea, among others. Diuretics control blood pressure by increasing the loss of salt and water via our urine. Under a normal state of health, meaning when we are not sick or experiencing any illness, diuretics do not lead to dehydration. This only occurs when we are already losing or unable to tolerate fluids. In these cases, diuretics can be like “adding fuel to the fire” and it would be best to hold these medications until you are feeling back to your normal self.
Other medications that can lead to dehydration when overused are laxatives. So, it is important to make sure you stop taking these once you notice signs of developing diarrhea, such as loose stools.
It is very important to seek medical care when you develop nausea and vomiting that is ongoing for more than 24 hours. In the case of diarrhea, since fluids are able to be tolerated orally and there is less of a risk that the stage of dehydration will be moderate to severe. However, if you have diarrhea for more than 48-72 hours, it is advised that you contact your physician. It is also very important to notify your physician immediately if there is any blood in your vomit or diarrhea.
Your physician may have you come in to their clinic or proceed directly to the ER depending of your stage of dehydration. They will examine you and ask you some questions to get an idea what tests to run.
When there is dehydration, the main treatment is to be rehydrated either orally or intravenously. If you are not able to tolerate any fluids orally, these can be replaced by an IV that places the fluid directly into your bloodstream. There may be other treatments or therapies that may be also started depending on the underlying cause of the dehydration. For example, in the case of a bladder infection, leading to nausea and vomiting, antibiotics can also be added to the management plan.
Prevention is key with dehydration. It is important to drink plenty of fluids, especially if you have a fever or will be outside on a very hot day. Sports drinks such as Gatorade or any electrolyte replacement such as Pedialyte work the best because these also replace the lost electrolytes besides the fluid.
On a regular day, when you are in your normal state of health, water is fine. However, in early stages of dehydration, you can’t rely on just water since it does not contain the electrolytes that are lost during vomiting, excessive sweating or diarrhea. Electrolytes, such as sodium, potassium and calcium, among others are important because they keep our body functioning correctly.
Jennifer Santana, M.D., is board certified in Nephrology and Internal Medicine. She practices at Southern Kidney Specialists in Franklin and she is also a credentialed physician at Williamson Medical Center. Her office can be reached by calling 615-628-8064.Share this Article