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Dehydration:- Sign and Symptoms, Causes, Diagnosis, Treatment, Prevention and Home Remedy of Dehydration

Dehydration means your body does not have as much water and fluids as it should. Dehydration can be caused by losing too much fluid, not drinking enough water or fluids, or a combination of both. The most common cause of dehydration in infants and children is loss through vomiting and diarrhea from a virus.

Because of their smaller body weights and higher turnover rates for water and electrolytes, infants and children are more susceptible to dehydration than adults. The elderly and those with an illness are also at higher risk.

Dehydration is classified as mild, moderate, or severe based on the percentage of body weight lost. When severe, dehydration is a life-threatening emergency.

Sign and Symptoms of Dehydration

In the early stages of dehydration, there are no signs or symptoms. Early features are difficult to detect but include dryness of mouth and thirst

As dehydration increases, signs and symptoms develop. These include: thirst, restless or irritable behaviour, decreased skin turgor, dry mucous membranes, sunken eyes, and absence of tears when crying vigorously.

Symptoms of early or mild dehydration include:

Flushed face

Extreme thirst, more than normal or unable to drink

Dry, warm skin

Cannot pass urine or reduced amounts, dark, yellow

Dizziness made worse when you are standing

Weakness

Cramping in the arms and legs

Crying with few or no tears

Sleepy or irritable

Headaches

Dry mouth, dry tongue; with thick saliva.

Symptoms of moderate to severe dehydration are as follows:

Low blood pressure

Fainting

Severe muscle contractions in the arms, legs, stomach, and back

Convulsions

Heart failure

Sunken dry eyes

Skin loses its firmness and looks wrinkled

Lack of elasticity of the skin

Rapid and deep breathing

Fast, weak pulse

In severe dehydration, these effects become more pronounced and the patient may develop evidence of hypovolaemic shock, including: diminished consciousness, lack of urine output, cool moist extremities, a rapid and feeble pulse (the radial pulse may be undetectable), low or undetectable blood pressure, and peripheral cyanosis. Death follows soon if rehydration is not started quickly.

Causes of Dehydration

The main causes of dehydration are as follows:

A. External or stress-related causes

Prolonged physical activity without consuming adequate water, especially in a hot environment.

Prolonged exposure to dry air, e.g. in high-flying airplanes

Survival situations, especially desert survival conditions

Blood loss or hypotension due to physical trauma

Diarrhea

Shock

Vomiting

B. Infectious diseases

Cholera

Gastroenteritis

Shigellosis

Yellow fever

C. Malnutrition

Electrolyte imbalance

a. Hypernatremia (also caused by dehydration)

b. Hyponatremia, especially from restricted salt diet excessive consumption of alcohol

Fasting

Patient refusal of nutrition and hydration

Diagnosis of Dehydration

Your doctor can often diagnose dehydration on the basis of physical symptoms such as little or no urination, sunken eyes and skin that lacks its normal elasticity and resilience when pinched. If you're dehydrated, you're also likely to have low blood pressure, especially when moving from a prone to a standing position, a faster than normal heart rate and reduced blood flow to your extremities.

To help confirm the diagnosis and pinpoint the degree of dehydration, you may have other tests, such as:

Blood tests . These may be used to check your electrolytes; especially sodium and potassium; to look for signs of concentrated blood; and to evaluate how well your kidneys are working.

Urinanalysis. The color and clarity of your urine, the presence of carbon compounds and your urine's specific gravity - that is, the mass of the urine as compared with equal amounts of distilled water - all help show whether you're dehydrated and to what degree. A high specific gravity, for example, indicates significant dehydration.

If it's not obvious why you're dehydrated, your doctor may order additional tests to check for diabetes and for liver or kidney problems.

Treatment of Dehydration

Drinking fluids is usually sufficient for mild dehydration. It is better to have frequent, small amounts of fluid (using a teaspoon or syringe for an infant or child) rather than trying to force large amounts of fluid at one time. Drinking too much fluid at once can bring on more vomiting.

Electrolyte solutions or freezer pops are especially effective. These are available at pharmacies. Sport drinks contain a lot of sugar and can cause or worsen diarrhea. In infants and children, avoid using water as the primary replacement fluid.

Intravenous fluids and hospitalization may be necessary for moderate to severe dehydration. The doctor will try to identify and then treat the cause of the dehydration.

Most cases of stomach viruses tend to resolve on their own after a few days.

Prevention in Dehydration

The best way to prevent dehydration is to make sure kids gets plenty of fluids, whether they're sick or just physically active. In other words, you need to make sure that they're consuming more fluids than they're losing (from vomiting, diarrhea, or sweating).

The way you should keep a child adequately hydrated will differ depending on the circumstances. For example, a child with a sore throat may become dehydrated due to difficulty drinking or eating. Easing the pain with acetaminophen or ibuprofen may help. Cold drinks or popsicles can also soothe a burning throat while supplying fluids at the same time.

Infants with blocked noses who have trouble feeding can be helped by flushing their nostrils with saltwater, or saline, nose drops and suctioning out the mucus with a bulb syringe.

Fever, which can be a factor in dehydration in any infectious disease, can be controlled with medications or room-temperature sponge baths and dressing the child in light clothing.

On hot, dry, and windy days, it's important that children drink often. Those who participate in sports or strenuous activities should also drink some extra fluid before the activity begins. They should also drink at regular intervals (every 20 minutes) during the course of the activity and after the activity ends.

Thirst is not a good early indicator of dehydration. By the time a child feels thirsty, he or she may already be dehydrated. And thirst can be quenched before the necessary body fluids have been replaced. That's why it's recommended to start drinking before thirst develops and to drink some additional fluid even after thirst is quenched. Sports practices and competitions should be scheduled in the early morning or late afternoon to avoid the hottest part of the day.

Children with mild gastroenteritis who aren't dehydrated should continue to eat normally but should be encouraged to drink additional fluid to replace fluid losses. According to the American Academy of Pediatrics, recent studies have shown that most children with gastroenteritis can safely eat a regular age-appropriate diet while they're sick. In fact, feeding a regular diet to children who have diarrhea may even reduce the duration of diarrhea, while offering proper nutrition at the same time. Infants with mild gastroenteritis who aren't dehydrated should continue to drink breast milk or regular-strength formula. Older children may continue to drink full-strength milk.

Foods that are usually well tolerated by children with gastroenteritis who aren't dehydrated include: complex carbohydrates (such as rice, wheat, potatoes, bread, and cereals), lean meats, yogurt, fruits, and vegetables. Avoid fatty foods or foods high in simple sugars. If the child is vomiting and isn't dehydrated, give fluids frequently, but in small amounts.

General Home Care

Try to get people who are dehydrated to take in fluids in the following ways:

Sip small amounts of water.

Drink carbohydrate/electrolyte-containing drinks. Good choices are sports drinks such as Gatorade or prepared replacement solutions.

Suck on ice chips.

Sip through a straw

Try to cool the person, if there has been heat exposure or if the person has an elevated temperature, in the following ways:

Remove any excess clothing and loosen other clothing.

Air-conditioned areas are best for helping return body temperatures to normal and break the heat exposure cycle.

If air conditioning is not available, increase cooling by evaporation by placing the person near fans or in the shade, if outside. Place a wet towel around the person.

If available, use a spray bottle or misters to spray luke-warm water on exposed skin surfaces to help with cooling by evaporation.

Avoid exposing skin to excessive cold, such as ice packs or ice water. This can cause the blood vessels in the skin to constrict and will decrease rather than increase heat loss. Exposure to excessive cold can also cause shivering, which will increase body temperature-the opposite effect you're trying to achieve.

DIET

Once the child is rehydrated, an age-appropriate diet should be started. Children with dehydration from gastroenteritis have decreased duration of diarrhea when feedings are rapidly restarted.

Diluting milk or formula is not indicated. Breast-feeding should be resumed as soon as possible.

Foods containing complex carbohydrates (eg, rice, wheat, potatoes, bread, cereals) lean meats, fruits, and vegetables are encouraged. Fatty foods and simple carbohydrates should be avoided.

Benefits of Goof Dehydration

Boosts physical and mental endurance.

Helps prevent muscle cramps in your legs, hands, and feet -- and achy stiffness in your joints.

Some studies show hydration can decrease the risk of kidney stones and lower the risk of certain cancers by helping the body to flush out toxins.

Helps keep your digestive system working. Fluids soften the stools, making them easier to pass.

Helps prevent urinary tract infections by helping to flush away bacteria.

Can help asthmatics breathe more efficiently, according to experts. Apparently, dehydration interferes with how well the lungs function

Home Remedy of Dehydration

To stop vomiting, do not eat for several hours or until you are feel­ing better.

Take frequent; small sips of water or a rehydration drink.

To prevent dehydration, start taking small sips of water or rehy­dration fluid

even if you are still having diarrhea or vomiting.

If vomiting or diarrhea lasts longer than 24 hours, use only a rehydration

drink to restore lost electrolytes. Do not give the homemade drink to chidren

under 12.

Watch for signs of more severe dehydration

For infants and children under four:

Give small sips of a rehydration rink as soon as vomiting or diarrhea starts.

CALL THE DOCTOR

If someone cannot down even small sips of liquid after 12 hours of no food or drink.

If the following signs of severe dehydration develop:

Sunken eyes, no tears, dry mouth and tongue

Sunken soft spot on an infant's head

Little or no urine for eight hours

Skin that is doughy or doesn't bounce back when pinched

Rapid breathing and heartbeat

Sleepy, difficult to wake up, list less, and extremely irritable

If vomiting lasts longer than 24hours in an adult.

If severe diarrhea (large loose stools every one to two hours) lasts longer than two days in an adult.


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