Dehydration | ORS | oral rehydration therapy

Dehydration-

Dehydration is defined as excessive loss of water from the body. 

Body requires certain amount of fluid intake daily for normal functions. 

Minimum daily requirement of water intake is about 1 L. This varies with the age
and activity of the individual.
The most active individuals need 2 to 3 L of water intake daily.

Dehydration occurs 
when fluid loss is more than what is consumed.

Classification of dehydration-
Basically, dehydration is of three types:

1. Mild dehydration:
 It occurs when fluid loss is about 5% of total body fluids. Dehydration is not very serious and can be treated easily by rehydration.

2. Moderate dehydration:
 It occurs when fluid loss is about 10%. Dehydration becomes little serious and immediate treatment should be given by rehydration.

3. Severe dehydration:
 It occurs when fluid loss is about 15%. Dehydration becomes severe and requires hospitalization and emergency treatment.

When fluid loss is more than 15%, dehydration 
becomes very severe and life threatening. 

On the basis of ratio between water loss and sodium loss, dehydration is classified into three types:
1. Isotonic dehydration: 
Balanced loss of water and sodium as in the case of diarrhea or vomiting.

2. Hypertonic dehydration:
Loss of more water than sodium as in the case of fever.

3. Hypotonic dehydration: 
Loss of more sodium than water as in the case of excess use of diuretics.

Causes
1. Severe diarrhea and vomiting due to gastrointestinal disorders
2. Excess urinary output due to renal disorders
3. Excess loss of water through urine due to endocrine disorders such as diabetes mellitus, diabetes insipidus and adrenal insufficiency

4. Insufficient intake of water
5. Prolonged physical activity withoutconsuming
adequate amount of water in hot environment

6. Excess sweating leading to heat frustration
(extreme loss of water, heat and energy). Severe
sweating and dehydration occur while spending
longer periods on regular basis in the saunas

7. Use of laxatives or diuretics in order to lose weight quickly. This is common in athletes.

Signs and Symptoms-
Mild and moderate dehydration
1. Dryness of the mouth
2. Excess thirst
3. Decrease in sweating
4. Decrease in urine formation
5. Headache
6. Dizziness
7. Weakness
8. Cramps in legs and arms.

Severe dehydration
1. Decrease in blood volume
2. Decrease in cardiac output
3. Low blood pressure
4. Hypovolemic cardiac shock
5. Fainting.

Very severe dehydration
1. Damage of organs like brain, liver and kidneys
2. Mental depression and confusion
3. Renal failure
4. Convulsions
5. Coma.

Dehydration in Infants
Infants suffering from severe diarrhea and vomiting caused by bacterial or viral infection, develop dehydra-tion.
It becomes life threatening if the lost body fluids are not replaced.
This happens when parents are unable to recognize the signs.

Aging Effects on Dehydration

Elders are at higher risk for dehydration even if they are healthy. It is because of increased fluid loss and decreased fluid intake.
In some cases, severe dehydra-tion in old age may be fatal.

Treatment

Treatment depends upon the severity of dehydration.
 In mild dehydration,
 the best treatment is drinking of water
and stopping fluid loss.

 in severe dehydration
drinking water alone is ineffective because it cannot compensate the salt loss. So the effective treatment for severe dehydration is oral rehydration therapy. 

Oral rehydration therapy (ORS)

Oral rehydration therapy (ORT) is the treatment for dehydration in which a oral rehydration solution (ORS) is administered orally.

ORS was formulated by World Health Organization (WHO). 

Contents of ORS-
This solution contains
-anhydrous glucose,
-sodium chloride,
-potassium chloride
-trisodium citrate.

In case of very severe dehydration, proper treatment is the intravenous administration of necessary water and electrolytes.