Water is life

Job Osazuwa                                  

The dry season is here and the heatwave is gradually becoming unbearable in many parts of the country, which leads to many people being knocked down with dehydration.

The popular saying that “water is life” has been proven to be true in all ramifications. To survive on daily basis, a certain level of amount of water is needed by all humans, animals and other living things. Unarguably, water is such an essential product that its availability, cleanliness and access are of national and international concern.

Unlike food, in which an individual could survive for three weeks, he or she is said to be able only to live without water for one week. At least 60 per cent of the adult body is made of it, and every living cell in the body needs it to keep functioning. Water acts as a lubricant for our joints, regulates our body temperature through sweating and respiration, and helps to flush waste.

Dehydration happens when your body doesn’t have as much water as it needs. It has been revealed that without enough water, the body can’t function properly. You can have mild, moderate, or severe dehydration depending on how much fluid is missing from your body. The human body is roughly 75 per cent water.

It’s normal to lose water from one’s body every day by sweating, breathing, peeing, and pooping, and through tears and saliva (spit). Usually one replaces the lost liquid by drinking fluids and eating foods that contain water.

A sophisticated water management system keeps the body’s water levels balanced, and the body’s thirst mechanism tells people when they need to increase fluid intake. Dehydration is easy to remedy but can be serious if left unchecked.

A general practitioner and public health physician, who is based in Lagos, Dr. Anthony Opeyemi, explained that dehydration occurs when more water and fluids leave the body than enter it. He said that even low levels of dehydration could cause headaches, lethargy, constipation and other complications.

He warned that older people are commonly dehydrated compared to younger adults. He said the body is configured by God in such a way that water is found inside cells, within blood vessels, and between cells.

He enlightened that although water is constantly lost throughout the day as we breathe, sweat, urinate, and defecate, humans can replenish the water in their body by drinking fluids. He stated it was worthy to note that the body was configured to be able to also move water around to areas where it is needed most if dehydration begins to occur.

Most occurrences of dehydration can be easily reversed by increasing fluid intake, but he warned that severe cases of dehydration become an emergency that would require immediate medical attention.

Fast facts about dehydration

Around three-quarters of the human body is water. The causes of dehydration include diarrhoea, vomiting, and sweating. Individuals that are more at risk of dehydration include athletes, people at higher altitudes, and older adults. Early symptoms of dehydration include dry mouth, lethargy, and dizziness.

Symptoms

The first symptoms of dehydration include thirst, darker urine, and decreased urine production. In fact, urine colour is one of the best indicators of a person’s hydration level – clear urine means you are well hydrated and darker urine means you are dehydrated.

However, it is important to note that, particularly in older adults, dehydration can occur without thirst. This is why medics have advised that it is important for people to drink more water when ill, or during hotter weather.

As the condition progresses to moderate dehydration, symptoms include: Dry mouth, lethargy, weakness in muscles, headache and dizziness.

Severe dehydration, which is loss of 10-15 per cent of the body’s water may be characterized by extreme versions of the symptoms above as well as: Lack of sweating, sunken eyes, shrivelled and dry skin, low blood pressure, increased heart rate, fever, delirium and unconsciousness.

Symptoms in children

In babies, there will be a sunken fontanel (soft spot on the top of the head); dry tongue and mouth; irritation; no tears when crying; sunken cheeks and/or eyes and no wet diaper for 3 or more hours.

Causes

The basic causes of dehydration are not taking in enough water, losing too much water, or a combination of both. Understandably, sometimes, it is not possible for people to consume enough fluids. Some of the reasons could be because they are too busy, lack the facilities or strength to drink, or are in an area without potable water (while hiking or camping, for example).

Additional causes of dehydration include: Diarrhoea – the most common cause of dehydration and related deaths. The large intestine absorbs water from food matter, and diarrhoea prevents this from happening. The body excretes too much water, leading to dehydration.

Another cause is vomiting. This leads to a loss of fluids and makes it difficult to replace water by drinking it.

Sweating – the body’s cooling mechanism releases a significant amount of water. Hot and humid weather and vigorous physical activity can further increase fluid loss from sweating. Similarly, a fever can cause an increase in sweating and may dehydrate the patient, especially if there is also diarrhoea and vomiting.

A medical condition called diabetes, which is high blood sugar levels causes increased urination and fluid loss. Frequent urination is usually caused by uncontrolled diabetes, but also can be due to alcohol and medications such as diuretics, antihistamines, blood pressure medications, and antipsychotics.

When burns, blood vessels can become damaged, causing fluid to leak into the surrounding tissues.

Risk factors

Although dehydration can happen to anyone, some sets of people are at a greater risk. Those at most risk include: Older adults commonly become dehydrated. People that are at higher altitudes.

Athletes, especially those in endurance events, such as marathons, triathlons, and cycling tournaments are at great risk. Dehydration can undermine performance in sports, as experts have repeatedly said.

People with chronic illnesses, such as diabetes, kidney disease, cystic fibrosis, alcoholism, and adrenal gland disorders stand at risk too. Others are infants and children – most commonly due to diarrhoea and vomiting.

Dehydration in older adults is also common; sometimes this occurs because they drink less water so that they do not need to get up for the toilet as often. There are also changes in the brain meaning that thirst does not always occur.

Complications

If dehydration is not checked, it can lead to serious complications; these can include: Low blood volume – less blood produces a drop in blood pressure and a reduction in the amount of oxygen reaching tissues; this can be life threatening.

It can also lead to seizures – due to an imbalance of electrolytes; kidney problems – including kidney stones, urinary tract infections, and eventually kidney failure. The danger of heat injury – ranging from mild cramps to heat exhaustion or even heat stroke also loom.

Diagnosis

A doctor will use both physical and mental exams to diagnose dehydration. A patient presenting symptoms such as disorientation, low blood pressure, rapid heartbeat, fever, lack of sweat, and inelastic skin will usually be considered dehydrated.

Blood tests are often employed to test kidney function and to check sodium, potassium, and other electrolyte levels. Electrolytes are chemicals that regulate hydration in the body and are crucial for nerve and muscle function. A urine analysis will provide very useful information to help diagnose dehydration. In a dehydrated person, urine will be darker in colour and more concentrated – containing a certain level of compounds called ketones.

To diagnose dehydration in infants, doctors usually check for a sunken soft spot on the skull. They may also look for a loss of sweat and certain muscle tone characteristics.

Treatments

Dehydration must be treated by replenishing the fluid level in the body. This can be done by consuming clear fluids such as water, clear broths, frozen water or ice pops, or sports drinks, such as Gatorade and others in that category. Doctors have said that some dehydration patients, however, will require intravenous fluids in order to rehydrate. People who are dehydrated should avoid drinks containing caffeine such as coffee, tea, and sodas.

Underlying conditions that are causing dehydration should also be treated with the appropriate medication. This may include medication available to purchase over-the-counter or online, such as anti-diarrhoea medicines, anti-emetics (stop vomiting), and anti-fever medicines.

Prevention

Prevention is really the most important treatment for dehydration. Consuming plenty of fluids and foods that have high water content (such as fruits and vegetables) should be enough for most people to prevent dehydration.

People should be cautious about doing activities during extreme heat or the hottest part of the day, and anyone who is exercising should make replenishing fluids a priority.

Since the elderly and very young are most at risk of being dehydrated, special attention should be given to them to make sure they are receiving enough fluids.

Heat exhaustion

Heat exhaustion occurs when the body becomes dehydrated and is unable to regulate its internal body temperature. The condition is not usually considered life-threatening and it is treatable with fluids and rest.

A combination of exercise and warm weather may cause heat exhaustion. Normally, the body gets rid of excess internal heat by pumping blood to the surface of the skin and releasing sweat. Warm, moist air absorbs less sweat from the skin and limits the body’s ability to cool itself by sweating.

When the body is dehydrated, it lacks water and essential salts called electrolytes, which reduces its ability to sweat. If a person is unable to cool down by sweating, they may experience heat exhaustion.

Heat exhaustion usually causes a rise in body temperature, even though it can sometimes cause a person to feel cool.

Symptoms of heat exhaustion may include excessive sweating, dizziness and headaches. The symptoms of heat exhaustion can be easy to overlook and are similar to those of many other medical conditions, especially dehydration. Other common causes are: Weak, rapid pulse, excessive sweating, increased internal body temperature, muscle weakness or cramps, nausea, headache, dizziness, cold, pale, damp skin, sometimes accompanied by goosebumps and low blood pressure or light-headedness when standing up or bending over. Others are vomiting, irritable or aggressive behaviour, flushed face, rapid and shallow breathing.

Symptoms of heat exhaustion in children are similar to those in adults; they may: Seem excessively tired, be unusually thirsty and have cool, clammy skin. If they are old enough, they might complain of stomach or leg cramps. It is important to treat a child with heat exhaustion immediately.

If heat exhaustion is left untreated, it can lead to heatstroke. However, unlike heatstroke, which can be life-threatening, heat exhaustion does not cause impaired mental function, confusion, or loss of consciousness. Cases of heat exhaustion are also distinguished from heatstroke because a person’s internal body temperature does not go above 103°F.

Heat stroke is less common than heat exhaustion but more serious; it puts strain on the heart, lungs, kidneys, and liver. Heat exhaustion is most often caused by a combination of physical exertion and warm weather.

Additional factors known to increase the likelihood of heat exhaustion include: High humidity, usually over 60 per cent, liver or kidney conditions, intense, strenuous physical work, underlying conditions that increase the chances of dehydration, including diabetes or hyperglycaemia. Other factors are injuries where a portion of the body is compressed or pinned down by a heavy object, also known as crush injuries, drug abuse, heavy or long-term alcohol use, smoking or tobacco use, being overweight, certain medications, especially those that increase the risk of dehydration, including medications for depression, insomnia, allergies, and poor circulation, high blood pressure and heart disease.

On its own, heat exhaustion is not considered a major health concern. If left untreated, however, heat exhaustion can lead to heatstroke and further complications, including brain damage and organ failure. In rare cases, when heat exhaustion is accompanied by intense exercise or other medical conditions, it may cause a serious health risk.

To tackle heat exhaustion, alongside drinking fluids, heat exhaustion may be treated by moving to a cool and shaded area. If heat exhaustion is suspected, a person should stop doing exercise or physical activity immediately. A person with heat exhaustion should also drink fluids as soon as possible.

Further tips for treating heat exhaustion include: Seeking out a cool, shaded area or going indoors, loosening clothing, lying flat on the back, taking a lukewarm or cool shower, placing a cool and wet cloth on the face and chest. In severe cases, putting ice packs under each armpit and behind the neck, drinking one litre per hour of drinks that contain electrolytes, such as Gatorade or Gastrolyte are advised.

How to rehydrate

Make an at-home oral-rehydration solution by following these steps: Boil five cups (one litter) of water; remove from the heat source and stir in six teaspoons of sugar and half teaspoon of table salt; cool before drinking; add natural flavourings in the form of fruit juices, honey, or maple syrup.

Some drinks and foods can also act as oral-rehydrating formulas, including: Gruel (cooked cereal and water); rice water or congee; green coconut water; fresh fruit juices, ideally orange, pear, or peach; non-caffeinated tea; carrot soup; and banana puree mixed with water.