Disease Topics:Dehydration

Dehydration in Adults Overview

 

Dehydration is a condition that occurs when the loss of body fluids, mostly water, exceeds the amount that is taken in. With dehydration, more water is moving out of our cells and bodies than what we take in through drinking.

We lose water every day in the form of water vapor in the breath we exhale and in our excreted sweat, urine, and stool. Along with the water, small amounts of salts are also lost.

 

When we lose too much water, our bodies may become out of balance or dehydrated. Severe dehydration can lead to death.

Causes of Dehydration in Adults

Many conditions may cause rapid and continued fluid losses and lead to dehydration:

  • Fever, heat exposure, and too much exercise
  • Vomitingdiarrhea, and increased urination due to infection
  • Diseases such as diabetes
  • The inability to seek appropriate water and food (as in the case of a disabled person)
  • An impaired ability to drink (for instance, someone in a coma or on a respirator)
  • No access to safe drinking water
  • Significant injuries to skin, such as burns or mouth sores, or severe skin diseases or infections (water is lost through the damaged skin)

Symptoms of Dehydration in Adults

The signs and symptoms of dehydration range from minor to severe and include:

Urine color may indicate dehydration. If urine is concentrated and deeply yellow or amber, you may be dehydrated.

 

When to Seek Medical CareExams and Tests

 

The doctor may perform a variety of simple tests at the examination or send blood or urine samples to the laboratory. Through tests and examination, the doctor will try to identify the underlying cause or causes that led to the dehydration.

  • Vital signs
    • Fever, increased heart rate, decreased blood pressure, and faster breathing are signs of potential dehydration and other illnesses.
    • Taking the pulse and blood pressure while the person is lying down and then after standing up for 1 and 3 minutes can help determine the degree of dehydration. Normally, when you have been lying down and then stand up, there is a small drop in blood pressure for a few seconds. The heart rate speeds up, and blood pressure goes back to normal. However, when there is not enough fluid in the blood because of dehydration and the heart rate speeds up, not enough blood is getting to the brain. The brain senses this condition, and the heartbeats faster. If you are dehydrated, you feel dizzy and faint after standing up.
  • Urinalysis 
    • The color and clarity of urine, the urine specific gravity (the mass of urine is compared with that of equal amounts of distilled water), and the presence of ketones (carbon compounds that signify dehydration) in the urine may all help to indicate the degree of dehydration.
    • Increased glucose in the urine may lead to a diagnosis of diabetesor indicate loss of diabetic control and a cause for the dehydration.
    • Excessive protein in the urine may signal kidney problems.
    • Signs of infections or other diseases, such as liver disease, may be found by urine testing.
  • Blood chemistries
    • The amount of salts (sodium and potassium) and sugar, as well as indicators of kidney function (BUN and creatinine), may be important to evaluate the degree of dehydration and possible causes.
    • complete blood count (CBC) may be ordered if the doctor thinks an underlying infection is causing the dehydration. Other blood tests, such as liver function tests, may be indicated to find causes of the symptoms.
 

Call your doctor if the dehydrated person experiences any of the following:

  • Increased or constant vomiting for more than a day
  • Fever over 101°F
  • Diarrhea for more than 2 days
  • Weight loss 
  • Decreased urine production
  • Confusion
  • Weakness

Take the person to the hospital's emergency department if these situations occur:

  • Fever higher than 103°F
  • Confusion
  • Sluggishness (lethargy)
  • Headache 
  • Seizures 
  • Difficulty breathing
  • Chest or abdominal pains
  • Fainting
  • No urine in the last 12 hours

 

Dehydration in Adults Treatment - Self-Care at Home

Try to get people who are dehydrated (even those who have been vomiting) to take in fluids in the following ways:

Treatments and drugs

 

The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause.

Treating dehydration in sick children

Your doctor can offer specific suggestions for treating dehydration in your child, but some general guidelines include the following:

  • Use an oral rehydration solution. Unless your doctor advises otherwise, use an oral rehydration solution such as Pedialyte for infants and children who have diarrhea, vomiting or fever. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. They're also designed for easier digestion. Oral rehydration products are readily available in most drugstores, and many pharmacies carry their own brands. Begin giving fluids early in the course of an illness instead of waiting until the situation becomes urgent.

    Be sure to give enough solution. Your doctor may suggest specific amounts, depending on your child's age and degree of dehydration, but a general rule of thumb is to keep giving liquids slowly until your child's urine becomes clear in color. When your child is vomiting, try giving small amounts of solution at frequent intervals — try a spoonful or so every few minutes, for instance. If your child can't keep this down, wait 30 to 60 minutes and try again. Room temperature fluids are best.

  • Continue to breast-feed.Don't stop breast-feeding when your baby is sick, but offer your baby an oral rehydration solution in a bottle as well. If you give your baby formula, try switching to one that's lactose-free until diarrhea improves — lactose can be difficult to digest during diarrhea, making diarrhea worse. Never dilute formula more than the instructions advise. Your doctor may suggest substituting an oral rehydration solution for the formula for a short time.
  • Avoid certain foods and drinks. The best liquid for a sick child is an oral rehydration solution — plain water doesn't provide essential electrolytes, and although sports drinks replenish electrolytes, they replace those lost through sweating, not through diarrhea or vomiting. Milk, caffeinated beverages, fruit juices or gelatins don't relieve dehydration and may make children's diarrhea symptoms worse.

Treating dehydration in sick adults

Most adults with mild to moderate dehydration from diarrhea, vomiting or fever can improve their condition by drinking more water or other liquids. Certain liquids, such as fruit juices, carbonated beverages or coffee, can make diarrhea worse.

Treating dehydration in athletes of all ages

For exercise-related dehydration, cool water is your best bet. Sports drinks containing electrolytes and a carbohydrate solution also may be helpful. There's no need for salt tablets — too much salt can lead to hypernatremic dehydration, a condition in which your body not only is short of water but also carries an excess of sodium. Avoid drinking carbonated beverages, such as colas or other types of soda.

Treating severe dehydration

Children and adults who are severely dehydrated should be treated by emergency personnel arriving in an ambulance or in a hospital emergency room, where they can receive salts and fluids through a vein (intravenously) rather than by mouth. Intravenous hydration provides the body with water and essential nutrients much more quickly than oral solutions do — something that's essential in life-threatening situations.

 
  • Sipping small amounts of water
  • Drinking carbohydrate/electrolyte-containing drinks. Good choices are sports drinks such as Gatorade or prepared replacement solutions (Pedialyte is one example)
  • Sucking on popsicles made from juices and sports drinks
  • Sucking on ice chips
  • Sipping through a straw (works well for someone who has had jaw surgery or mouth sores)

Try to cool the person, if there has been heat exposure or if the person has an elevated temperature, in the following ways:

  • Remove any excess clothing and loosen other clothing.
  • Air-conditioned areas are best for helping return body temperatures to normal and break the heat exposure cycle.
  • If air conditioning is not available, increase cooling by evaporation by placing the person near fans or in the shade, if outside. Place a wet towel around the person.
  • If available, use a spray bottle or misters to spray lukewarm water on exposed skin surfaces to help with cooling by evaporation.
  • Avoid exposing skin to excessive cold, such as ice packs or ice water. This can cause the blood vessels in the skin to constrict and will decrease rather than increase heat loss. Exposure to excessive cold can also cause shivering, which will increase body temperature --the opposite effect you're trying to achieve.