Dehydration

Dehydration occurs when your body loses more fluid than you take in.

Information written and reviewed by Certified Doctors.

Contents

Key Information

What should I do?

If you think you have this condition, you may not need to see a doctor.

How is it diagnosed?

You may be able to recognise signs of dehydration yourself. A doctor can diagnose dehydration based on your history, symptoms and physical examination findings. A blood test might also be recommended to look at the balance of the salts in your blood.

What is the treatment?

If you have dehydration, then you need fluid therapy. It is important that you drink plenty of water or oral rehydration sachets. If you are unable to swallow liquids, fluids might be given in hospital through a vein in your arm.

When to worry?

If you develop any of the following symptoms, please see a doctor immediately:

  • loss of consciousness
  • unable to urinate for more than 6 hours
  • abnormally fast heart rate
  • palpitations (sensation of heart racing).

Introduction

Dehydration occurs when your body loses more fluid than you take in.

When the normal water content of your body is reduced, it upsets the balance of minerals (salts and sugar) in your body, which affects the way that it functions.

Water makes up over two-thirds of the healthy human body. It lubricates the joints and eyes, aids digestion, flushes out waste and toxins and keeps the skin healthy.

Some of the early warning signs of dehydration include:

  • feeling thirsty and lightheaded
  • having dark coloured, strong-smelling urine
  • passing urine less often than usual

A baby may be dehydrated if they:

  • have a sunken soft spot (fontanelle) on their head
  • have few or no tears when they cry
  • have fewer wet nappies
  • are drowsy

The body is affected even when you lose a small amount of fluid.

Read more about the symptoms of dehydration.

What causes dehydration?

Dehydration is usually caused by not drinking enough fluid or by fluid that is lost and not replaced. The climate, the amount of physical exercise you are doing and your diet can also contribute to dehydration.

You can also become dehydrated as a result of an illness, such as persistent vomiting and diarrhoea or sweating from a fever, or exercising in hot conditions.

Read more about the causes of dehydration.

Who is at risk from dehydration?

Anyone can become dehydrated, but certain groups are particularly at risk. These include:

  • babies and infants – they have a low body weight and are sensitive to even small amounts of fluid loss
  • older people – they may be less aware that they are becoming dehydrated and need to keep drinking fluids
  • people with a long-term health condition – such as diabetes or alcoholism
  • athletes – they lose a large amount of body fluid through sweat

What to do

Drink plenty of fluids if you're dehydrated. This can be water, semi-skimmed milk, diluted squash or fruit juice, but it's best to avoid caffeine and fizzy drinks.

If you're finding it difficult to keep water down because you're vomiting or have diarrhoea, try drinking small amounts more frequently.

Infants and children who are dehydrated shouldn't be given water as the main replacement fluid because it can dilute the already low level of minerals in their body and make the problem worse.

Instead, they should be given diluted squash, diluted fruit juice or a rehydration solution (available from pharmacies). You might find a teaspoon or syringe can be helpful for getting fluid into a young child.

If left untreated, severe dehydration can be serious and cause fits (seizures), brain damage and death.

Read more about treating dehydration.

When to see your doctor

See your doctor if your symptoms continue, despite drinking plenty of fluids, or if you suspect that your baby or toddler is dehydrated.

If your doctor suspects dehydration, you may have a blood test or a urine test to check the balance of salts (sodium and potassium) in your body.

Contact your doctor or out-of-hours service straight away if you have any of the following symptoms:

  • feeling tired (lethargic) or confused
  • dry mouth and eyes that don't produce tears
  • not passing urine for eight hours
  • dry skin that sags slowly into position when pinched up
  • rapid heartbeat
  • blood in your stools (faeces) or vomit
  • low blood pressure (hypotension)

You should also contact your doctor if your baby has passed six or more diarrhoeal stools in the past 24 hours, or if they have vomited three times or more in the past 24 hours.

Symptoms

Dehydration can be mild, moderate or severe, depending on how much of your body weight is lost through fluids.

Thirst is the first sign of dehydration. Other symptoms may include:

  • dizziness or light-headedness
  • headache
  • tiredness
  • dry mouth, lips and eyes
  • dark coloured urine
  • passing small amounts of urine infrequently (less than three or four times a day)

Dehydration can also lead to a loss of strength and stamina. It's the main cause of heat exhaustion.

You should be able to reverse dehydration at this stage by drinking more fluids, without medical attention.

If dehydration is ongoing (chronic), it can affect your kidney function and cause kidney stones to develop. It can also lead to:

  • liver, joint and muscle damage
  • cholesterol problems
  • constipation

When to see your doctor

See your doctor if your symptoms continue despite drinking fluids, or if you suspect that your baby or toddler is dehydrated.

You should also contact your doctor if your baby has passed six or more diarrhoeal stools in the past 24 hours, or if they have vomited three times or more in the past 24 hours.

If dehydration is suspected, you may be given a blood test or a urine test to check the balance of salts (sodium and potassium) in your body.

Severe dehydration

If dehydration is left untreated it can become severe.

Severe dehydration is a medical emergency and requires immediate medical attention.

Contact your doctor or out-of-hours service if you have any of the following symptoms:

  • feeling tired (lethargic) or confused
  • dry mouth and eyes that do not produce tears
  • not passing urine for eight hours
  • dry skin that sags slowly into position when pinched up
  • rapid heartbeat
  • blood in your stools (faeces) or vomit
  • low blood pressure (hypotension)
  • irritability
  • sunken eyes
  • a weak pulse
  • cool hands and feet
  • fits (seizures)
  • a low level of consciousness

If severe dehydration is not treated immediately, it can lead to complications. You can even die from severe dehydration because the blood stops circulating.

This level of dehydration needs hospital treatment and you will be put on a drip to restore the substantial loss of fluids.

Causes

Dehydration is caused by not drinking enough fluid or by losing more fluid than you take in. Fluid is lost through sweat, tears, vomiting, urine or diarrhoea.

The severity of dehydration can depend on a number of things, such as climate, level of physical activity and diet.

Types of dehydration

There are two types of dehydration. They are:

  • isotonic dehydration – where water and salt are lost in the same proportion as the water and salt in the fluid surrounding your cells; this type of dehydration is commonly caused by diarrhoea
  • hypernatraemic dehydration – which usually affects infants or children; 'hypernatraemic' means high levels of salt in the blood, so hypernatraemic dehydration is where a child loses relatively more water than salt – for example, when they have watery diarrhoea or excessive vomiting

There are several causes of dehydration, described below.

Illness

Dehydration is often the result of an illness, such as gastroenteritis, where fluid is lost through persistent bouts of diarrhoea and vomiting.

Sweating

You can also become dehydrated if you sweat excessively due to a fever, exercise and sport, or carrying out heavy, manual work in hot conditions.

In these situations, it's important to drink regularly to replace lost fluids. It doesn't necessarily need to be hot for you to lose a significant amount of fluid from sweating.

Children and teenagers are particularly at risk because they may ignore the symptoms of dehydration, or not know how to recognise and treat them.

Alcohol

Dehydration can also occur as a result of drinking too much alcohol. Alcohol is a diuretic, which means that it makes you pee more.

The headache associated with a hangover indicates that your body is dehydrated. You should try to drink plenty of water when you have been drinking alcohol.

Diabetes

If you have diabetes, you're at risk of becoming dehydrated because you have high levels of glucose in your bloodstream. Your kidneys will try to get rid of the glucose by creating more urine, so your body becomes dehydrated from going to the toilet more frequently.

Read more about the different types of diabetes.

Who's at risk?

The groups of people most at risk of dehydration are:

  • babies and infants – their low body weight makes them sensitive to even small amounts of fluid loss
  • older people – they may be less aware that they're becoming dehydrated and need to drink fluids
  • people with a long-term health condition – such as diabetes or alcoholism
  • athletes – they lose a large amount of body fluid through sweat

Treatment

The best way to treat dehydration is to rehydrate the body by drinking plenty of fluids, such as water, semi-skimmed milk, diluted squash or diluted fruit juice.

A sweet drink can help replace lost sugar and a salty snack can help replace lost salt.

Infants and children who are dehydrated shouldn't be given only water because it can dilute the already low level of minerals in their body and make the problem worse. Instead, they should have diluted squash, diluted fruit juice or a special rehydration solution (see below).

If you or your child is finding it difficult to hold down fluids because of vomiting or diarrhoea, take smaller amounts more frequently. You may find it easier to use a spoon or a syringe to give your child small amounts of fluid.

Read more about vomiting in adults and vomiting in children and babies.

Rehydration solutions

When you're dehydrated, you lose sugar and salts as well as water. Drinking a rehydration solution will enable you to re-establish the right balance of body fluids. The solution should contain a mixture of potassium and sodium salts, as well as glucose or starch.

There are several different rehydration products available over-the-counter from pharmacies or on prescription from your doctor, including solutions that are suitable for infants and children.

Ask your doctor or pharmacist for advice about the most suitable rehydration solution for you or your child.

Severe dehydration

Seek immediate medical help if you suspect someone is severely dehydrated (see symptoms of severe dehydration).

They may need to be admitted to hospital for treatment. In particular, babies, infants and elderly people will need urgent treatment if they become dehydrated.

Fluid may be given up the nose using a nasogastric tube or using a saline drip into a vein (intravenously). This will provide essential nutrients faster than using solutions that you drink.

If you have had bowel surgery, some rehydration solutions may not contain enough salt. In this case, you will need a higher-strength solution. Your doctor or surgeon will be able to recommend a suitable rehydration solution for you.

Prevention

You should drink plenty of fluids to avoid becoming dehydrated.

The Food Standards Agency (FSA) recommends that if you live in the UK (or somewhere with a similar climate), you should drink 1.2 lites (6-8) glasses of fluid every day.

As well as water, the FSA recommends drinking semi-skimmed milk, diluted squash and diluted fruit juice.

Drink regularly

If you're active, or if the weather is particularly hot, there's a greater risk that you will become dehydrated. To prevent becoming dehydrated, you should increase your fluid intake.

As different people sweat at different rates, it's very difficult to provide specific recommendations about how much fluid you should drink. However, you should drink more than normal while exercising, and it's particularly important to keep well hydrated if you're exercising in warm conditions. This is because you will sweat more and fluid will be lost from your body more rapidly.

However, drinking more fluid than your body can process can reduce the amount of sodium (salt) in your blood. This can lead to a serious and potentially fatal condition called hyponatremia. If you start to feel discomfort and bloating from drinking, stop drinking and allow time to recover.

Illness

If you, your child or someone you are caring for is ill, particularly with a fever, vomiting or diarrhoea, there's a high risk of becoming dehydrated so it's important to start replacing fluid as soon as possible.

Advice for children

There are no specific recommendations regarding the amount of water or other fluids that children need.

However, it's important for children to replace lost fluid to prevent dehydration. Like adults, children lose more water when they are in hotter climates and when they are physically active.

You should give your child healthy drinks as part of an overall healthy, balanced diet.

Content supplied by NHS Choices