Many of us know the dizziness, fatigue, and cramping that come with being dehydrated or volume depleted. Understanding why dehydration occurs and how to recognize it in our family members is more difficult. As winter approaches, this becomes increasingly important as causes of dehydration including norovirus, “stomach flu”, and “regular” flu, become more prevalent.
The most common cause of dehydration in both adults and children is increased loss via the gastrointestinal tract via vomiting or diarrhea. The human body secretes 4000ml (equal to 2 2 liter soda bottles) of fluid in the intestines daily, though most of this is reabsorbed. Anything that can cause diarrhea, vomiting, or interfere with this reabsorption can rapidly lead to much fluid loss. Other less common causes of fluid loss include burns, bleeding, excessive sweating, kidney issues, and diuretics (water pills).
One of the most common symptoms of dehydration is dizziness (more a feeling that you may faint or pass out than the room spinning) that initially may only occur when going from a sitting to standing position but when more severe, may occur all the time. Other early symptoms include low energy, thirst, decreased urination, and cramping. More severe dehydration can also lead to chest pain, abdominal pain, and confusion as the dehydration begins to impair blood flow to the heart, abdominal organs, and brain. For babies and children unable to vocalize, initial symptoms will be crankiness, decreased wet diapers, inability to make tears when crying, and dry mouth and lips. Older individuals may present with more vague symptoms and may, at baseline, have some of the more common symptoms of dehydration including dry mouth, speech difficulty, muscle weakness.
There are tests for dehydration including serial blood pressure and heart rate evaluation (Orthostatics), evaluation of the urine which may show a large amount of ketones or high specific gravity, and checking a complete metabolic panel which may show abnormal kidney function tests which can be common in dehydration.
The primary treatment of dehydration is fluid replacement – ideally orally but if one is unable to keep the fluids down, via an IV or intravenous line. Some fluids are better than others for rehydrating. For babies or young children, oral rehydration solution such as Pedialyte would work well. Breastfeeding should continue. For older children or adults, sports drinks such as Gatorade or Powerade work better than water, tea, or ginger ale.
If you feel that you need to be evaluated for possible dehydration, please seek medical attention which may include your local Piedmont Urgent Care by WellStreet location. We have the ability to evaluate dehydration, offer intravenous rehydration therapy, as well as attempt to identify and treat the source of the dehydration.