Dehydration occurs when the body loses too much fluid. 
This can happen when the individual does not drink enough water or loses large amounts of fluid through diarrhea , vomiting , perspiration or exercise.
If you do not drink the lost liquid, it can dehydrate.
Since approximately 75% of body weight is composed of water found inside the cells, inside the blood vessels and between the cells, in order to survive it is necessary to have a lot of fluid in the body.

Classification and types of dehydration

There are three types of dehydration:
1. Isotonic (or isosmotic) dehydration occurs when the person loses water and minerals in the same proportion.
In cells there must be a balance between water and minerals.
Generally this type of dehydration is caused by diarrhea.

2. Hypertonic dehydration usually affects infants or children.
Hypertonic means high levels of salt in the blood; therefore, this type of dehydration occurs when a child loses more water than salt.
For example, when the newborn has watery diarrhea or vomits excessively.

3. Hypotonic dehydration occurs when the loss of electrolytes, especially sodium, is greater than water loss.

What are the causes of dehydration?

Sometimes it is not possible to consume the necessary amount of fluids, for example because of many commitments, because the structures are lacking or because the person lives in an area without drinking water (for example, when trekking or camping).

Additional causes of dehydration are:

  • Diarrhea – the most common cause of dehydration and related deaths. The large intestine absorbs water from digested food; diarrhea prevents this function and causes dehydration.
  • Vomiting – causes fluid loss and difficulty in drinking.
  • Sweating – when body temperature rises, the body releases a significant amount of water as sweat. The hot, humid climate, coupled with intense physical activity, can further increase the loss of fluids through perspiration.
  • Diabetes – High blood sugar causes increased urination and a loss of fluids.
  • Frequent urination – usually caused by uncontrolled diabetes, but can also be caused by alcohol and diuretic medicines, antihistamines , medicines for high blood pressure and antipsychotics.
  • Burn – water seeps into damaged skin and the body loses fluids.
  • Inability to drink liquids – Inability to drink properly is another potential cause of dehydration, for example in the following cases:
    • Lack of water availability,
    • Severe nausea with or without vomiting,
    • Lack of strength to drink.

Diseases Diseases
that cause continuous vomiting or diarrhea can cause dehydration.
This is because vomiting and diarrhea can cause a lot of water loss from the body.
Electrolytes are essential substances for the functioning of cellular activity and are lost along with water.
Electrolytes are found in blood, urine and other body fluids.
Vomiting or diarrhea can alter these functions and cause serious complications such as stroke and coma .

Fever
In case of fever , the body loses fluids because it transpires heavily in an attempt to lower body temperature.
Often, the fever can cause a lot of sweat. If the person does not drink to recover the liquids, it can dehydrate.

Other Causes
The elderly have a greater chance of becoming dehydrated for the following reasons:

  • Do not drink water because they do not feel thirst like the younger people.
  • Kidneys do not work well.
  • They choose not to drink because of their inability to control their bladder ( incontinence ).
  • They take medicines that increase the production of urine.
  • They do not have enough money to feed themselves properly.
  • Have physical problems or a disease that causes:
    • Difficulty drinking or holding a glass.
    • Pain when getting up from the chair.
    • Pain or fatigue when going to the bathroom.
    • Difficulty talking or communicating with someone about the symptoms.

Dehydration in infants and young children

Babies and toddlers have a greater chance of becoming dehydrated because:

  • A higher percentage of body tissues is composed of water.
  • Children have a high metabolic rate and therefore the body uses more water.
  • A child’s kidneys do not retain water like the kidneys of an adult.
  • A child’s immune system is not fully developed and this increases the likelihood of having a disease that causes vomiting and diarrhea.
  • Children often do not eat or drink when they do not feel well.
  • Newborns depend on their mother for food and fluid intake.

 

Who is at risk of dehydration?

Although dehydration can occur at all, some people are at greater risk. The categories with the highest risk are:

  • People living at high altitudes;
  • Athletes, especially those who practice endurance sports like marathons, triathlon and cycling. Dehydration can worsen performance in sports;
  • People with chronic diseases such as diabetes, kidney disease, disorders of the adrenal glands, alcoholism and cystic fibrosis ;
  • Elderly, infants and children.

Symptoms of dehydration

It is important to recognize the symptoms of dehydration as soon as they occur.
Untreated dehydration can cause a shock .
Signs and symptoms of dehydration include:

How do you know if your child is dehydrated?
The symptoms that indicate if the child is dehydrated or if it is becoming dehydrated are:

  • More than six to eight hours without wetting the diaper;
  • Urine that appears darker in the diaper and smells stronger than usual;
  • Lethargy (excessive tiredness);
  • Dry and arid mouth and lips;
  • Lack of tears when she cries.

Signs that the child may be severely dehydrated:
1. Deep eyes;
2. Cold hands and feet, with spots on the skin ;
3. Excessive drowsiness ;
4. Sunken skull.

Complications of dehydration

Dehydration can cause serious complications, including:

Heat stroke
If we do not drink enough fluids while we are doing intense physical activity and sweat a lot, we can develop a heat stroke  ranging from mild crampsto a life-threatening illness.

Cerebral edema
Sometimes when we drink fluids after dehydration, the body tries to store a lot of water in the cells.
This can cause excessive swelling of brain cells and rupture.
The consequences are particularly serious when the brain cells are affected.

Seizures
Electrolytes such as potassium and sodium help carry the nerve signals from one cell to another.
If electrolytes are in balance, ordinary electrical messages can become confusing and this can cause involuntary muscle contractions and sometimes loss of consciousness.

Hypovolemic shock
This is one of the most serious and sometimes dangerous complications of dehydration.
It occurs when a reduction in blood volume causes a drop in blood pressure and the amount of oxygen in the body.

Kidney Failure
This potentially lethal problem occurs when the kidneys are no longer able to remove excess fluid and waste from the blood.

Eat and Death
If not treated properly, severe dehydration can be deadly.

Diagnosis of dehydration

Exams and Tests
A physical examination should look for the following signs:

  • Blood pressure that decreases when moving from the lying position to the upright position;
  • Low blood pressure ;
  • Skin tension; the skin may not be more elastic like before and after a pinch back very slowly to its original position (normally, the skin returns to normal immediately);
  • Rapid heart rate (tachycardia);
  • Shock.

Among the tests that are performed:

1. Blood tests (to check for  electrolytes , especially sodium, potassium and bicarbonate levels),
2. BUN: elevated urea nitrogen in the blood,
3. Complete blood count : the value of blood cells are higher,
4. Values ​​of elevated creatinine,
5. Specific urine weight .

Treatment for dehydration and natural remedies

Rehydration Solutions
When we are dehydrated, we lose sugar and salts along with water. Drinking a rehydration solution allows you to restore body fluid balance.
The solution should contain a mixture of potassium and sodium salts, as well as glucose or starch.
There are several rehydration products available in pharmacy with or without a doctor’s prescription, including suitable solutions for infants and children.

Severe dehydration
Anyone who suspects that a person is severely dehydrated should immediately call the emergency room.
Inpatient treatment may be required.
In particular, infants, children and the elderly urgently need treatment in case of dehydration.

The fluids may be administered through the nose through a nasogastric tube or using a serum in the vein (intravenous).
In this way, the essential nutrients are assimilated faster compared to drinking solutions.

The best way to treat dehydration is to rehydrate the body with plenty of liquid, such as water, semi-skimmed milk, diluted syrup or diluted fruit juice.
A sweet drink can help replenish lost sugar and savory snacks can help ingest the lost salt.

Infants and dehydrated children should not only drink water because it would dilute the already low level of minerals in the body and could make the problem worse.
Children need diluted syrup, fruit juice or a special rehydration solution.
If your child has difficulty drinking fluids because of vomiting or diarrhea, you may want to try to make small amounts of them often.
To give the child a small amount of liquid, it may be simpler to use a spoon or syringe.

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