Dehydration: All You Need To Know By Dr Prabhat Rajan Sinha

Summer has just begun, but the soaring temperatures are already setting new record highs regarding ‘hottest summer days.’ While we associate this season with holidays, outdoor activities like picnics, swimming or vacations, summer poses important health risks too. Dehydration is one of the most significant health concerns this season. Unbeknownst to many, dehydration can be dangerous if ignored or not appropriately treated. Also, dehydration is much more than just proper water intake.

To understand this condition better, Dr Prabhat Rajan Sinha, an internal medicine specialist at Aakash Healthcare, spoke to us at length on dehydration – its symptoms, cure and prevention.

What Is Dehydration?

The deficit of water and solutes in the body is called dehydration. The final symptom of this, due to excess perforation as solutes are being lost from the body, causes dehydration. The signs and symptoms are as follows – the patient may feel very tired and lazy. They may experience low BP, tachycardia or palpitations or may panic, feel anxious, etc. On examination, the mucous membrane, i.e. the skin within the mouth becomes completely dry and the skin elasticity decreases. When the patient of dehydration suffers low BP, their pulse rate is very high as the heart tries hard to compensate for the loss of fluids. The heart beats faster to pump blood and fluid requirements to the entire body.

What Are The Causes Of Dehydration?

In the summer season, if you are exposed to extreme heat, it causes a loss of fluids from the body. If you are a patient of gastroenteritis or diarrhoea which are common ailments in summer and if the patient is already borderline dehydrated, i.e. recurring vomiting or low intake of water, these are the leading causes of dehydration in summer. There are other organic causes like a patient with diabetes who has very high sugar (500 or 600). High sugar causes frequent urination which leads to dehydration.

How Much Water Should One Consume?

This entirely depends on your body’s requirements. On average, one and a half litres of water is a must. Every day our body, when we inhale and exhale, i.e. humidification of breath, plus the insensible loss, i.e. water going out of your body which is 700 to 800 ml. We lose water through the urine as well as the faeces where our body secretes up to a litre of water.

The requirement of water also depends on the amount of activity one does. Activities that demand a high level of exertion, tend to lose more water. Ideally, you should be able to maintain a proper level of hydration in the body.

In summer, it is best to consume 2.5 litres to 3 litres of water. But people who have sedentary jobs, sitting in air-conditioned offices all day long, even 2 litres of water is good. An important marker to check your level of hydration is the frequency of urination. It is ideal that every 4-5 hours, you should urinate, i.e. urine should at least 50ml per hour. If the bladder capacity of a person is 250 ml to 300 ml, they should feel an urge to urinate every 5-6 hours.

What Are The Symptoms Of Dehydration?

A patient will feel lethargic, palpitations or even feel feverish. They may complain of dizziness, feel low in energy. As the level of dehydration increases, the patient will experience severe symptoms. They may go into shock as the BP will rapidly fall. The patient may collapse or have a syncopal attack (fainting).

How To Treat Dehydration?

On examining the patient, it is important to understand the level of dehydration – is it mild, is it moderate or is it severe? If a patient has a history of dehydration or a patient is brought in when unconscious and their BP is less than 90, then we need to start the treatment accordingly. They must be given fluids containing solutes. In the beginning, the solutes are pushed faster to get the BP above 90 systolic, i.e. an upper level of BP. This is very important because if the BP remains below 90, it means that not all organs in the body are getting perfusion correctly. If it is mild dehydration, you can go slow and push the fluid with solutes slower at the rate of 60-100 ml per hour. But if the patient is in shock, we must push one litre of fluid in an hour. Additionally, the symptoms of dehydration should be treated too. If the patient has recurring vomiting, we need to address that as well or stop diarrhoea.

If the patient is suffering from a high fever, it is important to cool the patient down and bring down the temperature.

How To Prevent Dehydration?

Don’t step out in extreme heat. Avoid high-exertion activities in the afternoons as the fluid loss will be high. Ensure proper fluid intake and have fluids with solutes. Eat fruits and vegetables that have more water content. Maintain a proper diet and do not skip meals. Indulge in seasonal fruits – watermelon. Drink at least eight glasses of water.

How To Protect Ourselves From Extreme Heat?

Wear protective clothes, stay adequately covered. Wear cotton clothes and ditch the nylons or other synthetic materials. Wear colours like white, sky blue or other lighter, pastel shades. They reflect off the heat and don’t attract heat, unlike the darker shades, primarily black.

Who Is Most At Risk Of Dehydration?

Elderly. This is because as the age increases, the intake of fluids decreases. As we know, our body is made up of 33% water. But as we grow older, the water content in the body lowers and is replaced by fats in the case of the elderly and diabetic patients or other chronically ill patients. Even infants and small children are at risk.

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