Fluids enter the body by mouth but they exit in several ways: urination, sweating, breathing and absorption or elimination by the digestive tract. When there is not enough going in or too much leaving, the effects range from mild to drastic.A shortage of fluids causes the body to immediately conserve whatever is already stored in the body. Urination, sweating and dampness in exhaled air all diminish or cease and constipation occurs within hours or days, depending upon overall health, age and bodily reserves. Powerful thirst drives a person to consume fluids of all types and juicy foods to make up the deficit.Unless fluid intake is successful, signs of dehydration occur, the most obvious of which is ‘tenting’. Gently pinching up a bit of flesh on the back of the hand creates a small ‘tent’ which should fill and sink back if all is well. If there is dehydration, the tent stays up. Fluid replacement is then necessary, either by mouth or IV. If there is vomiting, fluids can also be administered by rectum.
A good example of sudden life-threatening dehydration is cholera. A healthy adult can die from cholera in 2-6 hours because of the acute and massive diarrhea it causes. There is no effective vaccine and antibiotics do not act quickly enough. All that is necessary to save lives is aggressive rehydration with a large amount of balanced salt solution. This can be given by mouth at home if started early enough.
When water is scarce, the body can exist, although not comfortably, in a state of constant slight dehydration. This shows mostly as constant thirst and some tenting. A population of people living where water is scarce and contaminated tip over into dangerous intestinal infections easily.
In Third World Countries, where poverty, disease and famine constantly undermine the health of the citizens, it doesn’t take much for young children, the ill and the elderly to succumb quickly to these infections. Their bodies are already weakened and they have little resistance. There is no clean drinking water and thirst drives them to drink whatever they can find.
Ordinary diarrhea kills more children in impoverished countries than all other causes combined and severely disables those adults who survive.
Carol Jordan was a medical professional administering bedside care in hospital settings for all her adult life until retirement. She specialized in emergency and ICU respiratory care for over thirty years