Dehydration


Dehydration in the body can be detected by several signs and symptoms – dry mount, thirst, sudden weight loss, delayed skin turgor and dark urine excretion in small amounts.

All of these symptoms will depend on the stage of the dehydration. For example, if you have mild dehydration, you will barely have any of these or any trouble even. If you happen to have severe dehydration, you can end up experiencing disabling fatigue and discard only small amounts or urine in brown color.

In case of mild dehydration, there might not be so much of thirst, but a dry mouth can be experienced. There could be a decreased urination and the urine can be of bright yellow color. In this case, the skin turgor will be less than 2 seconds and capillary refill will also be less than 2 seconds. There is about 1% to 3% of body weight loss. In case of moderate dehydration, there is about 4% to 6% body weight loss. In addition to the above mentioned symptoms, a patient is also likely to discard amber colored urine, dizziness or even fatigue. Here, the skin turgor can be less than 10 seconds and the capillary refill can take up to 2 to 4 seconds. For extreme cases, like in severe dehydration, there is more than 6% body weight loss. Here, there a lot more signs apart from the above mentioned symptoms for mild and moderate dehydration. For severe dehydration, there will be very minimal urination or in some cases, none whatsoever. The color of the urine can resemble that of tea. Apart from that, a person suffering from severe dehydration can complain of fainting, exhaustion or can even go into come. For such patients, the range of skin turgor is somewhere between 10 seconds to 1 minute. Capillary refill takes less than 3 seconds and the pulse will also be weak. Capillary refill is the time a nail takes to get back its original pink color after pressing it for a few seconds.

Dehydration

Mild Dehydration – Early Signs and Symptoms

1)For adults, when they end up losing about 1% to 3% of their body weight, they are considered to have mild dehydration. Let’s take a look at the above mentioned signs and symptoms in details:

Dryness of mouth: This is one of the earliest signs of dehydration. However, it’s not so reliable, because even if you are dehydrated, you can have a moist mouth if you are thinking about some food dishes you love. On the other hand, you can be very well hydrated, but might end up having a dry mouth in several cases. Some of them include:

  • Consumption of alcohol
  • Anxiety
  • Sjögren’s syndrome
  • Using the mouth to breathe
  • Having some strong emotions
  • Patriot glands inflammation
  • Taking some medicines in case of some medical conditions

2) Thirst: this is a typical sign of dehydration, but again, it is not reliable. One can feel thirsty after losing about 2% of the body weight. One can be very well dehydrated but not feel thirsty. In case of children of elders, they are not always much aware of their thirst. In other cases where either you are starving or fasting or don’t drink water or eat for many hours or even days, your body does not get any salt and that could also be a reason for not feeling any thirst. In other cases, you might not be having dehydration, but you might feel really thirsty because of dryness of mouth, some other psychological reasons (psychogenic polydipsia), eating really salty food, or seeing a drink that you love. In case of some other people, they have thirst which could be similar to the feeling of being hungry. Hence, when they are thirsty, they end up eating instead of drinking water. This is the reason why it is true that if you drink ample amount of water, you would not have as many cravings of food as you generally do.

3) Strong yellow colored urine and a decrease in urination: Some of the most common early signs of dehydration include:

  • A decrease in the frequency of urination during the day
  • A decrease in the amount of discarded urine during the mornings
  • The color of urine is darker than usual

4) Pounding heart: If you happen to be dehydrated, your blood volume will decrease. This will lead to the trigger of release of hormone epinephrine, that is, adrenaline from your adrenal glands. This in turn will lead to a constriction of arteries and stimulation of the heart for maintaining the normal rate of blood pressure. This kind of heart stimulation can make you experience a pounding heart.

5) Some other symptoms and signs of mild dehydration:

  • Constipation
  • Increased appetite
  • Decreased appetite
  • Reduced energy
  • Tiredness of body
  • Slight anxiety, especially for women
  • Mild headache

The abnormalities that a physical examiner can find during examination are called clinical signs. In case of mild dehydration, the first ones are:

  • A slight increase in the heart rate
  • Delay of about 2 seconds in skin turgor
  • Sudden weight loss – by sudden, it means within a few hours or few days up to 1% to 3%.

Moderate Dehydration symptoms & early signs

For adults, when they end up losing about 4% to 6% of their body weight, they are considered to have moderate dehydration. Let’s take a look at the above mentioned signs and symptoms in details:

Symptoms: In case of moderate dehydration, there could be a lot of symptoms. Some of them are – itchy throat or chapped lips, moderate headache, feeling old, vertigo, lightheadedness, dizziness, poor appetite, morning sickness (for women who are pregnant), vomiting, insomnia, drowsiness, difficulty in concentrating on things, sensitivity to noise and light, bad breath, impaired memory, nervousness, depression and anxiety. All of these symptoms including the ones in case of mild dehydration can be seen in a person suffering from moderate dehydration.

The clinical signs in case of moderate dehydration include: weakened arterial pulse, low grade fever, sunken, dry eyes, sudden body weight loss up to 3% to 6%, dark circles, delay up to 4 seconds in capillary refill time, delay up to 10 seconds in skin turgor, an increase in breathing rate, more than 28 per minute and a normal BP which might drop on raising up.

Severe Dehydration symptoms & signs

For adults, when they end up losing above 6% of their body weight, they are considered to have severe dehydration. Let’s take a look at the above mentioned signs and symptoms in details:

Some of the common symptoms of severe dehydration apart from the ones for mild and moderate include:

  • Passing out
  • Fainting
  • Very little amount of urination or none at all
  • Extreme thirst, or in some cases, none whatsoever
  • Apathy
  • Migraine
  • Severe headache
  • Confusion
  • Lethargy
  • Pain during urination
  • Brownish to tea colored urine
  • Itchy, dry skin
  • Even if the weather is hot, no sweating
  • Coma
  • Chest pain
  • Blurred vision or temporary loss of vision
  • Fingertips numbness or tingling because of hyperventilation
  • Seizures
  • Hallucinations
  • Pain in lower back in case of acute kidney failure because of
  • dehydration
  • Delirium
  • Irritability

The clinical sign for severe dehydration is the sudden body weight loss, which is greater than 6% of the body weight. The body temperature in such cases can be normal, or decreased for hypovolemic shock. In case of infections, heat exhaustion or heat stroke, it can increase. Some of the signs on the skin include:

  • Delay for more than 4 seconds in capillary refill time
  • Cool, dry, wrinkled and pale skin
  • Delay in skin turgor from about 10 seconds up to even several minutes
  • Flushed, hot or dry skin at the time of a heat stroke
  • Cool, sweaty and pale skin at the time of hypovolemic shock or heat exhaustion

There are some other effects as well, in case of severe dehydration. Let’s take a look:

  • Dry, and very sunken eyes
  • Dry mouth or dryness in mucous membranes
  • Chapped, cracked and dry lips
  • Swollen or yellowish to whitish tongue
  • Faint pulse
  • Increase in the heart rate to more than 140 per minute, or tachycardia
  • Parotitis, meaning swelling of parotid glands
  • Coma
  • Impaired consciousness
  • Blood pressure could be decreased or normal
  • Hypovolemic shock
  • Dropping of systolic pressure under 60 mm Hg
  • Hyperventilation – increased breathing
  • Respiratory depression – decreased breathing
  • Dyspnea – difficulty in breathing

In case of adults, there can be as much as 10% to 15% body weight loss for dehydration, and it can result in even death. Let’s take a look at some of such symptoms that are linked with dehydration:

  • Coughing due to triggering by scratchy, dry throat
  • Bloating due to the constipation which is caused because of dehydration
    Yawning which could happen because of a reduced sleep due to anxiety happening associated with the dehydration
  • Facing a difficulty in swallowing things because of the dryness of mouth
  • Cramps or stomach pain can happen when dehydrated because of diarrhea pertaining to gastroenteritis, or food poisoning
  • Nosebleeds due to dryness of nasal mucosa in cases of severe dehydration
  • Tinnitus or ringing in ears can happen temporarily prior to fainting in cases of severe dehydration

Apart from all the above mentioned symptoms for different levels of dehydration, there could appear some other symptoms as well, which are not at all typical for dehydration. Let’s take a look at them in details:

  1. Muscle cramps: For even the cases of severe dehydration, it can not necessarily cause cramps in the calf for endurance athletes. However, some doctors do believe that dehydration along with muscle fatigue can cause Charley horse or leg cramps. Twitching of eyes also can not necessarily result due to dehydration, but due to other accompanied disorders like hypokalemia. Tremors or shaking of hands is also typical of dehydration.
  2. Red eyes: Bloodshot, red eyes are not typically found in dehydration, but may be caused due to the irritation of dried eyes in cases of severe dehydration.
  3. Cloudy urine: for dehydration, the color of urine is either yellow, tea colored or at times even cloudy. For the urine which only is cloudy and not dark or yellow, it is caused not because of dehydration but because of a high protein diet, bladder or kidney infection, urinary stones or inflammation.
  4. Swollen uvula: As of now, there is no proof of dehydration due to uvulitis or swollen uvula.
  5. Hematuria: It is a condition where there in blood in urine which can happen due to cancer, infection, inflammation, or any urinary tract injury. Though it is highly unlikely that it can happen due to dehydration. However, for some athletes, they may have blood in their urine and this could be probably associated with dehydration.
  6. Swelling of lymph nodes: Again, there is no proof that dehydration can cause swollen lymph glands for armpits or neck. However, there is a possibility of otherwise normal functioning lymph glands being more palpable during dehydration as a result of shrinking of surrounding tissues.

Apart from these, even skin rash, knee pain, leg pain or jaundice are not typical symptoms of dehydration.

Read more about Dehydration Types – (Hypertonic \ Hypotonic\ Isotonic) Diagnosis & Causes

References

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