Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
We've all learned that fluid replacement is critical to
replace fluids lost when exercising, but drinking pure water exclusively isn't the safest choice for
those who participate in very strenuous or long-duration exercise.
When significant amounts of fluid are lost through
high-intensity exercise, replacement with water alone can lead to a chemical
imbalance in the body and deficiencies in electrolytes, which are nutrients
critical for organ
functioning. The electrolytes in our body include sodium, potassium, chloride,
calcium and phosphate, but sodium
is the substance of most concern when
replacing fluids lost through exercising.
Hyponatremia is a condition in which the body's stores of sodium are too low,
and this condition can result from drinking extreme amounts of water.
Hyponatremia can lead to confusion, lethargy, agitation, seizures, and in
extreme cases, even death. Early symptoms are nonspecific and subtle and may
include disorientation, nausea, or muscle
cramps. The symptoms of hyponatremia may also mimic those of dehydration, so athletes experiencing these symptoms may
be given more water to drink, further worsening the condition.
Water is a critical element of the body, and adequate hydration is a must to allow the body to function. Up to 75% of the body's weight is made up of water. Most of the water is found within the cells of the body (intracellular space). The rest is found in the extracellular space, which consists of the blood vessels (intravascular space) and the spaces between cells (interstitial space).
Dehydration occurs when the amount of water leaving the body is greater than
the amount being taken in. The body is very dynamic and always changing. This is
especially true with water in the body. We lose water routinely when we:
breathe and humidified air leaves the body (this can be seen on a cold
day (the breath you see in the air is water that has been exhaled);
sweat to cool the body; and
eliminate waste by urinating or having a bowel movement.
In a normal
day, a person has to drink a significant amount of water to replace this routine
loss.
The formula for daily fluid requirements depends upon an individual's weight.
Normally, fluid and weight are calculated using the metric system; however,
below is the approximation in imperial (American) units.
Body weight
Daily fluid requirements
(approximate)
10 pounds
15 ounces
20 pounds
30 ounces
30 pounds
40 ounces
40 pounds
45 ounces
50 pounds
50 ounces
75 pounds
55 ounces
100 pounds
50 ounces
150 pounds
65 ounces
200 pounds
70 ounces
If you would like to calculate your body weight and daily fluid requirements
using the metric system, please use this formula.
For the first 10kg (kilogram) of body weight the daily fluid intake required is 100cc per kg.
For the next 10kg of body weight, the fluid required is an additional 50 cc/kg.
For every additional kg of body weight, an additional 10cc/kg
The body is able to monitor the amount of fluid it needs to function. The
thirst mechanism signals the body to drink water when the body is dry. As well,
hormones like anti-diuretic hormone (ADH) work with the kidney to limit the
amount of water lost in the urine when the body needs to conserve water.
What causes dehydration?
Dehydration occurs because there is too much water lost, not enough water
taken in, or most often a combination of the two.
Diarrhea:Diarrhea is the most common reason
for a person to lose excess amounts of water. A significant
amount of water can be lost with each bowel movement. Worldwide, more than four
million children die each year because of dehydration from diarrhea.
Vomiting:Vomiting can also be a cause of fluid loss.
It is lost in the vomitus, but it is difficult for a person to
replace water by drinking it if they have nausea and are unable to tolerate liquids.
Sweat: The body can lose significant amounts of water when it tries to cool itself
by sweating. Whether the body is hot because of the environment (for example,
working in a warm environment), intense exercising in a hot environment, or because a
fever is present due to an
infection; the body uses water in the form of sweat to
cool itself. Depending upon weather conditions, a brisk walk may generate up to
16 ounces of sweat (a pound of water) to allow body cooling, and that water
needs to be replaced by the thirst mechanism signaling the person to drink
fluids.
Diabetes: In people with
diabetes, elevated blood sugar levels cause sugar to spill
into the urine and water then follows, which may cause significant dehydration. For
this reason, frequent urination and excessive thirst are among the
early symptoms of
diabetes.
Burns: The skin acts as a protective barrier for the body and is
also responsible for regulating fluid loss.
Burn victims become dehydrated because
the damaged skin cannot prevent fluid from seeping out of the body.
Other inflammatory diseases of the skin are also associated with fluid loss.
Inability to drink fluids: The inability to drink adequately is the other potential cause of
dehydration. Whether it is the lack of availability of water, intense nausea
with or without vomiting, or the lack of
strength to drink, this, coupled with routine or extraordinary
water losses can compound the degree of dehydration.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones symptoms and signs are, blood in the urine and pain in the abdomen, flank (lower back), or groin. A number of different conditions can lead to kidney stones including: gout, hypercalciuria, people with inflammatory bowel disease, kidney disease, and hypoparathyroidism. Some medications also increase the risk of kidney stones.
Staphylococcus or Staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a Staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
Kidney infection (pyelonephritis) usually is caused from bacteria that have spread from the bladder from a UTI (urinary tract infection), poor hygiene, sexual intercourse, pregnancy, catheter, cystoscope exam, surgery, kidney stones, or prostate enlargement. Symptoms of kidney infection include: back pain, frequent urination, pain during urination, fever, and or pus or blood in the urine. Kidney infection is usually treated with antibiotics.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Herpes simplex infections are common and when they appear around the mouth and lips, people often refer to them as "cold sores" and "fever blisters." Canker sores are different than cold sores. Air droplets can spread the virus, as can direct contact with the fluid from the blisters. Cold sore treatment include over-the-counter medication as well as prescription medications.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Clostridium difficile (C. difficile) is a bacterium, and is one of the most common causes of infection of the colon. C. difficile spores are found frequently in hospitals, nursing homes, extended care facilities, and nurseries for newborn infants. They can be found on bedpans, furniture, toilet seats, linens, telephones, stethoscopes, fingernails, rings, floors, infants' rooms, and diaper pails. They even can be carried by pets. Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. Treatment for C. difficile colitis hydration, replenishment of electrolyte deficiencies, discontinuing the antibiotic that caused the colitis, and using antibiotics to eradicate the C. difficile bacterium.
Dementia is a significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. There are different criteria classification schemes for dementias such as cortical, subcortical, progressive, primary, and secondary dementias. Other conditions and medication reactions can also cause dementia. Dementia is diagnosed based on a certain set of criteria. Treatment for dementia is generally focused on the symptoms of the disease.
Dry mouth is a common side effect of many prescription and non-prescription drugs. Symptoms of dry mouth include a sticky, dry feeling in the mouth, frequent thirst, sores in the mouth; sores or split skin at the corners of the mouth, cracked lips, a dry feeling in the throat, a b urning or tingling sensation in the mouth, and a dry, red, raw tongue.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Heat rash is a skin irritation caused by excessive sweating. It can occur at any age and it appears as a rash that itches or feels prickly, and looks like a red cluster of pimples or small blisters. Pictures of heat rash are included.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Norovirus infection causes stomach flu, or gastroenteritis. It's a very contagious illness with symptoms that include nausea and vomiting, diarrhea, stomach cramps, fever, headache, chills, and muscle aches. Norovirus infection cannot be treated with antibiotics, so treatment focuses on maintaining proper hydration.
Potassium is an essential electrolyte necessary for cell function. Low potassium (hypokalemia) may be caused by diarrhea, vomiting, ileostomy, colon polyps, laxative use, diuretics, elevated corticosteroid levels, renal artery stenosis, and renal tubular acidosis, or other medications. Symptoms of low potassium include weakness, aches, and cramps of the muscles. Treatment is dependant upon the cause of the low potassium (hypokalemia).
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Whooping cough (pertussis) is highly contagious respiratory infection that is caused by the bacteria Bordetella pertussis. There are an estimated 300,000 plus deaths annually from whooping cough (pertussis). Whopping cough commonly affects infants and young children, but can be prevented with immunization with the vaccine. First stage whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. After one to two weeks, the second stage of whooping cough begins.
Hyponatremia is a condition where the level of sodium in the blood is low. Causes of hyponatremia can occur from excess fluid in the body, or a loss of sodium in body fluid. Some of the symptoms of hyponatremia include headache, muscle cramps or spasm, seizures, weakness and confusion. Treatment of hyponatremia depends on the cause.
Polycythemia (elevated red blood cell count) causes are either primary (aquired or genetic mutations) or secondary (diseases, conditions, high altitude). Treatment of polycythemia depends on the cause.
Heat stroke (heatstroke or sun stroke) is a form of hyperthermia. Heat stroke is a true medical emergency that can be fatal if not promptly and properly treated. Symptoms of heat stroke include: high body temperature, absence of sweating, with hot red or flushed dry skin, rapid pulse, difficulty breathing, strange behavior, hallucinations, confusion, agitation, disorientation, seizure, and coma. A victim of heat stroke must receive immediate treatment to avoid permanent organ damage.
Salmonella bacteria are known to cause salmonellosis, typhoid fever, and paratyphoid fever in humans. Salmonella infection is usually caused by ingesting large amounts of the bacteria in contaminated food or water.
Cystic fibrosis is a disease of the mucus and sweat glands. Cystic fibrosis is an inherited disease. The outcome of the disease leaves the body malnourished, bulky and fouls smelling stools, vitamin insufficiency, gas, painful or swollen abdomen, infertility, susceptible to heat emergencies, and respiratory failure. There is no cure for cystic fibrosis, treatment of symptoms is used to manage the disease.
Huntington's disease is the result of degeneration of neurons in areas of the brain. Huntington's disease is an inherited disorder. Early symptoms include mood swings, apathy, depression, and anger uncharacteristic of the individual. Judgement, memory, and other cognitive functions may become impaired. Presymptomatic testing is available for individuals who have a family history of Huntington's disease. Treatment includes medication and therapy for symptoms.
Staphylococcus is a group of bacteria that can cause a number of diseases as a result of infection of various tissues of the body.
Staphylococcus is more familiarly known as Staph (pronounced "staff"). Staph-related illness can range from mild and requiring no treatment to severe and potentially fatal.
The name Staphylococcus comes from the Greek staphyle, meaning a bunch of grapes, and
kokkos, meaning berry, and that is what Staph bacteria look like under the microscope, like a bunch of grapes or little round berries. (In technical terms, these are gram-positive, facultative anaerobic, usually unencapsulated cocci.)
Over 30 different types of Staphylococci can infect humans, but most infections are caused by
Staphylococcus aureus. Staphylococci can be found normally in the nose and on the skin (and less commonly in other locations) of 25%-30% of healthy adults. In the majo...
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