Dehydration Health Article

Treatment

Increased fluid intake and replacement of lost electrolytes are usually sufficient to restore fluid balances in patients who are mildly or moderately dehydrated. For individuals who are mildly dehydrated, just drinking plain water may be all the treatment that is needed. Adults who need to replace lost electrolytes may drink sports beverages (e.g., Gatorade or Recharge) or consume a little additional salt. Parents should follow label instructions when giving children Pedialyte or other commercial products recommended to relieve dehydration. Children who are dehydrated should receive only clear fluids for the first 24 hours.

A child who is vomiting should sip one or two teaspoons of liquid every 10 minutes. A child who is less than a year old and who is not vomiting should be given one tablespoon of liquid every 20 minutes. A child who is more than one year old and who is not vomiting should take two tablespoons of liquid every 30 minutes. A baby who is being breast-fed should be given clear liquids for two consecutive feedings before breastfeeding is resumed. A bottle-fed baby should be given formula diluted to half its strength for the first 24 hours after developing symptoms of dehydration.

In order to accurately calculate fluid loss, it's important to chart weight changes every day and keep a record of how many times a patient vomits or has diarrhea. Parents should note how many times a baby's diaper must be changed.

Children and adults can gradually return to their normal diet after they have stopped vomiting and no longer have diarrhea. Bland foods should be reintroduced first, with other foods added as the digestive system is able to tolerate them. Milk, ice cream, cheese, and butter should not be eaten until 72 hours after symptoms have disappeared.

Medical care

Severe dehydration can require hospitalization and intravenous fluid replacement. If an individual's blood pressure drops enough to cause or threaten the development of shock, medical treatment is usually required. A doctor should be notified whenever an infant or child exhibits signs of dehydration or a parent is concerned that a stomach virus or other acute illness may lead to dehydration.

A doctor should also be notified if:

• a child less than three months old develops a fever higher than 100°F (37.8°C)
• a child more than three months old develops a fever higher than 102°F (38.9°C)
• symptoms of dehydration worsen
• an individual urinates very sparingly or does not urinate at all during a six-hour period
• dizziness, listlessness, or excessive thirst occur
• a person who is dieting and using diuretics loses more than 3 lb (1.3 kg) in a day or more than 5 lb (2.3 kg) a week

When treating dehydration, the underlying cause must also be addressed. For example, if dehydration is caused by vomiting or diarrhea, medications may be prescribed to resolve these symptoms. Patients who are dehydrated due to diabetes, kidney disease, or adrenal gland disorders must receive treatment for these conditions as well as for the resulting dehydration.

Alternative treatment

Gelatin water can be substituted for electrolyte-replacement solutions. It is made by diluting a 3-oz package in a quart of water or by adding one-quarter teaspoon of salt and a tablespoon of sugar to a pint of water.

Prognosis

Mild dehydration rarely results in complications. If the cause is eliminated and lost fluid is replaced, mild dehydration can usually be cured in 24–48 hours.

Vomiting and diarrhea that continue for several days without adequate fluid replacement can be fatal. The risk of life-threatening complications is greater for young children and the elderly. However, dehydration that is rapidly recognized and treated has a good outcome.

Prevention

Patients who are vomiting or who have diarrhea can prevent dehydration by drinking enough fluid for their urine to remain the color of pale straw. Ensuring that patients always drink adequate fluids during an illness will help prevent dehydration. Infants and young children with diarrhea and vomiting can be given electrolyte solutions such as Pedialyte to help prevent dehydration. People who are not ill can maintain proper fluid balance by drinking several glasses of water before going outside on a hot day. It is also a good idea to avoid coffee and tea, which increase body temperature and water loss.

Patients should know whether any medication they are taking can cause dehydration and should get prompt medical care to correct any underlying condition that increases the risk of dehydration.

Other methods of preventing dehydration and ensuring adequate fluid intake include:

• eating more soup at mealtime
• drinking plenty of water and juice at mealtime and between meals
• keeping a glass of water nearby when working or relaxing

BOOKS

Larson, David, E., ed. Mayo Clinic Family Health Book. New York: William Morrow, 1990.