Symptoms: Feeling very thirsty, dry mouth, dry skin, dark-coloured urine, sweating and urinating less than usual.

Causes: Heat, diarrhoea, vomiting, sweating or urinating too much, and not drinking enough fluids.

Risk Factors: Exercise, heat exposure, medications, illnesses, and fluid loss. 

Severity: Mild to severe

Which doctor to consult: General physician

OVERVIEW:

Dehydration is a condition caused by the loss of too much fluid from the body. It happens when you are losing more fluids than you are taking in, and your body does not have enough fluids to work properly.

The most common cause of dehydration is diarrhoea and vomiting. Not drinking enough fluids, vigorous exercise, sweating and urinating too much, vomiting, and diarrhoea increase the risk of dehydration.

Anyone can become dehydrated, but young children and older adults are usually at risk. Mild to moderate dehydration can be treated by drinking more fluids, but severe dehydration requires prompt medical attention.

SYMPTOMS:

The symptoms of dehydration in adults are:

• Feeling very thirsty

• Urinating and sweating less than usual

• Dry mouth

• Dry skin

• Feeling tired

• Dark-coloured urine

• Dizziness

The symptoms of dehydration in infants and young children are:

• Crying without tears

• Dry mouth and tongue

• High fever

• No wet diaper for more than 3 hours

• Irritability

• Sunken eyes

• Unusually sleepy or drowsy

Dehydration can be mild, moderate or severe. 

Signs of mild to moderate dehydration include:

• Thirst

• Dry or sticky mouth

• Darker yellow urine

• Headache

• Muscle cramps

• Not urinating much

• Dry/cool skin

Seek immediate medical attention if you notice symptoms of severe dehydration. Signs of severe dehydration include:

• Not urinating, or very dark yellow or amber-colored urine

• Irritability or confusion

• Dry, shrivelled skin

• Sunken eyes

• Dizziness or lightheadedness

• Rapid heartbeat

• Rapid breathing

• Fatigue

• Shock (not enough blood flow through the body)

• Unconsciousness

CAUSES:

Dehydration could occur due to the following conditions:

• Diarrhoea & Vomiting: Severe and sudden diarrhoea can cause a significant loss of fluids and electrolytes in a short period of time. If vomiting accompanies diarrhoea, the body loses even more fluids and minerals, which might lead to dehydration.

• Increased urination: This may be due to undiagnosed or uncontrolled diabetes. Certain medications, such as diuretics and some blood pressure medications, also can lead to dehydration, generally because they cause you to urinate more.

• Excessive sweating: You lose fluid when you sweat. If you engage in strenuous activity and don't replenish fluids as you go, you may become dehydrated. Hot and humid weather causes you to sweat more and lose more fluid.

• Not drinking enough water/fluids: Not drinking enough water because you are sick or busy or due to lack of water in case of travelling may lead to electrolyte imbalance, leading to dehydration.

• Fever: In general, if you have a fever along with diarrhoea and vomiting, you are more likely to become dehydrated.

RISK FACTORS:

Anyone can become dehydrated, but certain people are at greater risk:

Infants and children: Infants and children are the most susceptible to severe diarrhoea and vomiting, which can lead to dehydration. Due to their young age, they may not be able to communicate their thirst or get a drink for themselves.

Older adults: As individuals grow older, their body's capacity to retain fluids decreases, making it harder for them to conserve water and recognise when they are thirsty. These difficulties are further exacerbated by chronic diseases like diabetes and dementia, as well as the use of specific medications. Additionally, seniors may face mobility issues that hinder their ability to access water independently.

People with chronic illnesses: If you have unmanaged or untreated diabetes, dehydration becomes a significant risk for you. The risk of dehydration also increases if you have kidney disease or if you take medications that increase urine production. Furthermore, even a simple cold or sore throat can make you more prone to dehydration since you are less likely to feel like consuming food or liquids when sick.

People who work or exercise outside: The risk of dehydration and heat illness increases during hot and humid weather. This is because in humid conditions, sweat does not evaporate as quickly as it normally does, and therefore, it cannot cool the body as effectively. Consequently, the body temperature can increase, leading to a higher demand for fluids to prevent dehydration.

People taking medicines: Certain medications like anti-hypertensives, diuretics, laxatives and chemotherapy agents may increase urination or cause excess sweating which could cause dehydration.

POSSIBLE COMPLICATIONS:

Dehydration can lead to serious complications, including:

Heat injury: If one fails to consume adequate fluids during vigorous exercise and heavy perspiration, heat injuries may occur. These injuries can range in severity from mild heat cramps to heat exhaustion or even life-threatening heatstroke.

Urinary and kidney problems: Urinary tract infections, kidney stones, and even kidney failure can occur due to prolonged or recurring dehydration.

Seizures: Electrolytes such as potassium and sodium are responsible for carrying electrical signals from cell to cell. When the balance of these electrolytes is disrupted, the normal electrical messages can become jumbled up. This can result in involuntary muscle contractions and may even lead to loss of consciousness.

Low blood volume shock (hypovolemic shock): Dehydration can cause a severe and life-threatening complication known as hypovolemic shock. This condition arises due to a decrease in blood volume, resulting in a drop in blood pressure and reduced oxygen levels in the body.

PREVENTION:

Make sure to consume a sufficient amount of fluids and include watery fruits and vegetables in your diet to avoid dehydration. For most healthy individuals, relying on your thirst to dictate your daily fluid intake is sufficient. However, individuals with certain conditions might need to increase their fluid intake.

Vomiting or diarrhoea: It is important to begin giving your child extra water or oral rehydration solution as soon as you notice any signs of vomiting or diarrhoea. Waiting until dehydration sets in can be risky.

Strenuous exercise: To prepare for intense exercise, it is recommended to begin hydrating the day before. If your urine is clear and diluted, it is a sign that you have sufficient hydration levels. While participating in the activity, make sure to drink fluids at regular intervals. After finishing, continue to consume water or other liquids to replenish fluids.

Hot or cold weather: Drinking more water is necessary in hot and humid weather to reduce body temperature and replenish fluids lost through sweating. When the air is dry, especially at higher altitudes, you may need to drink more water to prevent moisture loss in cold weather.

Illness: Older individuals are at a higher risk of becoming dehydrated during minor illnesses, such as influenza, bronchitis, or bladder infections. It is recommended to consume extra fluids when feeling unwell to avoid dehydration.

Tips to prevent dehydration:

• Drink enough fluids even if you are well. 

• Drink more fluids particularly if the weather is hot or if you are exercising.

• Do not wait for signs of dehydration, and drink plenty of fluids if you have diarrhoea or vomiting.

• Try taking small sips of water or sucking on ice chips if you have trouble keeping liquids down.

• Be mindful of sports drinks as they have a lot of sugar. Do not consume them excessively.

• Avoid consuming sugary drinks, alcohol, soda or caffeine as they may worsen the condition.

WHEN TO SEE A DOCTOR:

Seek medical attention if you have the following:

• Diarrhoea for 24 hours or more

• Very dark urine or no urination

• Feeling confused and disoriented

• Feeling dizzy on standing up

• Have had a seizure

• Experiencing rapid or weak pulse

• Dry skin which has lost its elasticity

• Sunken eyes

DIAGNOSIS:

Your physician can typically identify dehydration by observing physical indicators and symptoms. If you are dehydrated, you may experience low blood pressure, particularly when transitioning from a lying to an upright position, an elevated heart rate and decreased blood circulation to your limbs. 

Other examinations, such as the following, may be necessary to confirm the diagnosis and determine the extent of dehydration:

Blood tests: Blood tests help determine the levels of electrolytes in your body, particularly sodium and potassium, in addition to assessing the functionality of your kidneys.

Urinalysis: Urine tests can determine the level of dehydration you may be experiencing. Additionally, it can detect any indications of a bladder infection.

TREATMENT:

Replacing lost fluids and electrolytes is the only way to effectively treat dehydration. The appropriate dehydration treatment approach depends on the age of the person, the cause of dehydration, and the severity of the condition.

For people experiencing diarrhoea & vomiting: When children are suffering from diarrhoea, vomiting or fever, it is recommended to use an oral rehydration solution (ORS), which contains water and salts in specific proportions and helps to replenish fluids and electrolytes. If an adult is experiencing mild to moderate dehydration due to diarrhoea, vomiting or fever, they can improve their condition by drinking more water or other liquids. However, it is important to know that full-strength fruit juice and soft drinks may worsen diarrhoea.

For individuals who exercise: When the weather is hot or humid, it's best to have cool water if you are working or exercising outside. It may also be beneficial to consume sports drinks that contain electrolytes and carbohydrates.

For people who are severely dehydrated: Emergency medical attention is required for both children and adults who are severely dehydrated. The delivery of salts and fluids through an intravenous (IV) line is a fast-acting method of absorption that helps accelerate the recovery process.