A Patient is Admitted to the Hospital That is Dehydrated as the Result of Continuous Diarrhea

Being hospitalized for dehydration is more common than you think. In my personal experience as a doctor taking care of hospitalized patients, I have treated thousands of patients hospitalized for dehydration. However, only a small percentage of patients need hospitalization for dehydration. It is important to understand when you need to seek urgent help for severe dehydration, because it can lead to complications. What makes an episode of dehydration severe not only depends on the degree of dehydration, but also depends on your overall health condition.

In this article, I will list a few different examples of when you may need hospitalization for dehydration based on your general health and pre-existing conditions. I will also list some common symptoms of dehydration. You will then know what to expect when hospitalized for dehydration. I will also describe potentially life-threatening complications of dehydration and what you can do to avoid them.

A chart showing factors that can lead to hospitalization for dehydration

When do you need to be hospitalized for dehydration?

When you need to be hospitalized for dehydration depends on who you are and your overall health condition. I will list a few specific categories and explain when you need to be hospitalized for dehydration based on who you are.

When you need to be hospitalized for dehydration if you are an otherwise young and healthy adult

It is very rare to be hospitalized for dehydration if you are a healthy young adult. However, there are certain situations where it would be necessary.

Here are the specific situations when you may need to be hospitalized for dehydration even as a healthy and young adult:

1. Severe dehydration cause by food poisoning: There are many types of food poisoning, and symptoms may range from mild to severe. Food poisoning is different from a foodborne infection. Spoiled food that causes food poisoning already has the toxins in it. These toxins are made by the bacteria that spoiled the food. These bacteria may be destroyed while cooking, but the toxins remain. You know you have food poisoning rather than a foodborne illness when your symptoms start within hours of eating the food. In severe cases, you have uncontrollable vomiting. With some specific toxins, you may get severe watery diarrhea too. You lose fluids rapidly from your body and are unable to rehydrate yourself because of the persistent vomiting. This may lead to being hospitalized for dehydration even when you are young, healthy, and otherwise strong.
2. Severe dehydration caused by undiagnosed diabetes: You may be young and otherwise healthy, but may not have known that you are diabetic. It happens to many adults; the first time they seek medical care is when they develop symptoms of severe dehydration.
3. Severe dehydration caused by a lack of access to food and drink: This happens when you are lost or abandoned and need rescue. You may have become lost while hiking in the mountains or trapped in a cave. When you are rescued after a few days, you will definitely need to be hospitalized for dehydration.

When you need to be hospitalized for dehydration if you are elderly

Unfortunately, it does not take much for elderly patients to become severely dehydrated. It is important to get medical attention if you have someone older than 75 that appears dehydrated. You need to look out for signs and symptoms of dehydration anytime your elderly parents or relatives are sick. Even a minor illness can push them towards dehydration.

Here are some specific things that can make elderly people so dehydrated that they need to be hospitalized urgently:

1. Minor stomach bug: Unlike young and healthy people, the elderly may get hospitalized for dehydration with a simple infection of the stomach and intestines. What is commonly called a "stomach bug" is called gastroenteritis in medical terms, and it is caused by common viruses. Unlike food poisoning, gastroenteritis symptoms start more gradually, and could only be a minor inconvenience for most healthy and young adults. They mostly get different degrees of nausea, vomiting, abdominal cramps, and diarrhea. However, these same symptoms may push elderly towards the edge and may make them severely dehydrated, especially when they are unable to keep food or drink down because of vomiting. Many of them need urgent hospitalization for dehydration to prevent complications.
2. Urine infection: In my experience of treating hospitalized elderly patients with dehydration, a urine infection is the most common condition leading to dehydration. A urine infection in the elderly may have very non-specific symptoms, and they may only seek medical attention when they are too weak or when they fall down at home. People who are 75 years of age or older do not have much reserve, and may need hospitalization for dehydration even with a simple UTI (urinary tract infection).
3. Pneumonia in the elderly: Pneumonia in the elderly is also a common reason for the elderly to get hospitalized with dehydration. Visit this link if you want to learn everything you need to know about the different types of pneumonia and their symptoms. Elderly patients with pneumonia have a decreased appetite and weakness from pneumonia; they do not eat and drink enough when they get sick. It makes them even sicker, and they may have complications. They need to be hospitalized and treated for dehydration as well as pneumonia.
4. Elderly with other medical problems: Many diseases and conditions as well as medications used to treat health problems can cause dehydration. I will specifically discuss certain pre-existing conditions that make you vulnerable to being hospitalized for severe dehydration. It is important to note that elderly patients with those medical issues are significantly more vulnerable to severe dehydration requiring hospitalization than their younger counterparts.

When you need to be hospitalized for dehydration if you have a specific pre-existing condition

1. Uncontrolled diabetes: Dehydration from uncontrolled blood sugars in diabetics can quickly get worse. The higher your blood sugar goes, the more you urinate and lose water. The exact mechanism of dehydration from diabetes is a little more complex, but I have explained it in a way that you can easily understand in the article "Dehydration from Diabetes". When diabetics get dehydrated, they can develop complications earlier than non-diabetics. It is important to get them hospitalized for dehydration before it is too late.
2. Patients taking diuretics: There are certain medical conditions such as chronic heart failure where you need to take medications called diuretics. These medications are supposed to force excess water and salt out in your urine. If you are on these medications, you may get dehydrated quickly if you get sick. You may need to be hospitalized for dehydration if you get sick while taking these medications.
3. Patients getting dialysis: Balancing the amount of water is always a challenge in patients getting regular dialysis. They have problems with too much water in the body if enough of it is not removed during dialysis. However, they may also get dehydrated quickly if too much fluid is removed. It is especially true if they are also suffering from an infection, vomiting, diarrhea, or any other illness that can make them more dehydrated. Dialysis patients frequently need to be hospitalized for dehydration when they get sick.

Common symptoms of dehydration

Symptoms of dehydration can be really hard to assess. It mostly depends on the underlying cause of dehydration. However, people that need to be hospitalized for dehydration have some common signs and symptoms that you can look out for.

Here is the list:

1. Dry mouth
2. Increased thirst
3. Decreased urine output
4. Dry skin with a dull appearance and decreased elasticity
5. Sunken eyes
6. Dry eyes
7. Difficulty concentrating
8. Dizziness and lightheadedness
9. Headaches
10. High heart rate and palpitations
11. Feeling like you are fainting
12. Confusion and delirium
13. Low blood pressure

What to expect when hospitalized for dehydration

The treatment of dehydration in a hospital includes the treatment for the underlying cause of dehydration, which could be diabetes, a urine infection, pneumonia, etc. In addition to the specific treatment for their underlying medical problems, most patients who get hospitalized for dehydration can expect to receive the following interventions:

1. Getting IV lines placed and getting started on IV fluids
2. Frequent checking of vital signs including blood pressure and the pulse
3. Having a heart monitor placed if electrolyte imbalance (see complications section below to understand what it is) is detected
4. Frequent blood tests to follow electrolytes and kidney function
5. Tracking of how much urine you make
6. Anti-nausea medications to prevent vomiting
7. Encouraged to drink more water if you are not vomiting
8. Assessment of your mental status to make sure you are not confused or disoriented

Potential life-threatening complications of dehydration

I have described the symptoms, risk factors, and usual treatment of severe dehydration requiring hospitalization. Until you understand the potential complications that may happen with severe dehydration, you still do not understand why someone needs to be hospitalized for dehydration.

Here are some possible complications of severe dehydration:

1. Kidney failure: When you get severely dehydrated, your blood volume goes down. Your kidneys may shut down to prevent any further water loss in your urine. When kidneys keep themselves shut down for too long, there could be permanent damage to your kidneys. Read this article if you want to understand more about the mechanisms of kidney damage from dehydration: "Reversible kidney damage from dehydration."
2. Shock: Continued severe dehydration will keep lowering your blood volume down. It comes to a point when your body cannot sustain the very low blood volume, and it collapses. Your blood pressure goes way down and you go into shock. Shock from severe blood volume loss can be fatal if not treated urgently.
3. Abnormal heart rhythm: Severe dehydration may imbalance the electrolytes in your blood. Electrolytes are charged ions of important chemicals such as sodium, potassium, chloride, and calcium. These particles are very important in the normal electrical activity of major organs, including your heart. Electrolyte imbalance may interfere with your heart rhythm, and it can lead to complications.
4. Brain injury: Rapid loss of blood volume and low blood pressure may damage your brain.

In conclusion, severe dehydration is a serious medical condition that needs urgent evaluation and possible hospitalization. It is important to recognize when your loved ones could be getting severe dehydration, especially when they are elderly and weak.

References:

https://academic.oup.com/ageing/article/44/6/943/80322

https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.84.8.1265

https://www.sciencedirect.com/science/article/abs/pii/S1525861008001072

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Source: https://patienteducationmd.com/hospitalized-for-dehydration/

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