Drinking water can be harmful
Risk of overhydration
When outside temperature rises, experts warn that we should drink plenty of water. However, not everyone should drink a lot of water. Sometimes this warning reaches the person when the damage is already done. In the worst case you can drown yourself, because the body can’t cope with too much water. Particularly severe heart patients, kidney patients and liver patients are at risk of overhydration.
Water is healthy
Usually drinking water is healthy. In healthy population mostly someone can't drink too much water. About 80% of our water intake comes from drinking liquids. We also get a lot of water from food, especially from products that contain a lot of water. Soup, pudding, yoghurt but also fruits and some vegetables contain a relatively large amount of water. The recommended amount of beverages would be about 9-12.5 cups (1,5 litre) a day.
We need water because it helps us with a lot of body processes. Water regulates our body temperature. Fluid improves the digestion and also the processing of food. It transports vitamins, minerals and nutrients to our cells. The absorption of nutrients is easier with water and it helps us to get rid of waste. The human body contains about 50% (women) to 63 % (men) water, which we partially lose again. Babies even consist of 75 percent water. Moisture loss takes place by urine, faeces, breath and through the skin. In warm weather, we get rid of extra fluid and it is important to replenish the lost fluids.
There are some groups at higher risk of dehydration, in particular the following people
- Children, especially babies and toddlers
- Chronical illness
- Illness because of an infection
- When suffering to fever and diarrhea
- Living in a hot climate, especcialy when physically active
- Older people, they have decreased thirst stimulus
- People with obesity or after gastric bypass surgery
Risks of drinking too much water
However, in a number of cases water drinking can be dangerous. Especially when you are familiar to an illness in which there is a fluid restriction. For some people, the amount of water does not even have to be big to get into severe trouble. The body cannot handle the excess of water, after which the accumulated water can cause harmful consequences.
Specific groups of people with serious illness are advised to restrict fluid intake. In the initial phase of the illness, the necessity for fluid restriction is not always known to the patient and people who take care of that person. It happens frequently that an acute hospitalization is needed by drinking too much water. Hot weather periods are notorious because of the advised extra intake of liquid. Medical problems are piling up quickly when the body gets overhydrated. During the acute hospitalization people are informed about the recommended fluid intake. In addition to the fluid restriction, diuretics and salt (sodium) restriction is prescribed, because the body also builds up fluid by salt.
Are you familiar with fluid restriction?
Diseases with fluid restrictions
Heart patients suffering heart failure
Heart failure is a complex set of interrelated symptoms. The heart doesn't pump out enough blood, whereby moisture can't be removed from the tissue. As a result the body holds more and more moisture. The first signs of moisture problems mostly are swollen ankles and feet. Often, weight increases quickly by fluid retention. Usually we find dyspnea and fatigue. In severe cases, there is more and more moisture between the lung membranes, or even in the lungs. Shortness of breath arises. When a large amount of fluid accumulates in the lungs (acute pulmonary edema), medical help is immediately necessary. Medication to drive off moisture and reduce stuffiness will be quickly given to the patient.
Fluid reduction in heart failure
In heart failure, it may be necessary to limit the amount of fluid. The heart will be relieved and can exert its function better. Not only the amount of water has to be calculated, but also the moisture in other beverages. Sometimes it is even necessary to count the amount of moisture from fruit and vegetables. In a fluid restriction for heart failure, the usually advised maximum total intake is 6-8 cups / 1500 ml a day.
How heart failure causes fluid accumulation
Kidney and liver patients
With impaired renal function the kidneys can't properly get rid of excess water. The fluid may be excreted through the urine but accumulates in the body tissue. Apart from fluid retention increased blood pressure may occur. Also, the removal of toxins from the blood takes place to a reduced extent. When the amount of circulating toxins is too large it can also cause health problems. As the kidneys become less functioning, the fluid intake has to be reduced. Generally the more urine a patient produces, the more fluid they can drink.
In severe liver disease the body can also retain too much fluid . A swollen abdomen is a symptom of a serious liver disease. In hepatic impairment due to cirrhosis, edema can occur (fluid retention). Sometimes liver moisture is leaking into the abdomen (ascites). Most patients with cirrhosis do not need to limit fluid intake, unless the sodium level is too low (hyponatremia). Medical advice on the amount of moisture and nutrition is necessary to maintain or to improve the nutritional status. Ask your hepatologist (liver specialist) whether you need to watch your fluid intake
Tips to limit fluids
- A lot of food contains fluids, such as soups, custard and ice cream.
- Use small cups and glasses for all your liquids.
- Take your pills with food, soup or custard, so your liquid intake will become less.
- Use spreadable toppings (e.g. jam, pate or cheese spread). This makes the meal smoother so you'll need to drink less.
- Sucking on a hard candy or peppermint increases saliva production.
- Chew (sugar-free) gum, frozen vegetables of fruit when you're thirsty.
- Alcohol is not recommended because it can reduce the pumping function of the heart.
- Rince your mouth with cold water and spit it out afterwards.
- Breathe through your nose and not your mouth.
- Brush your teeth frequently.
- Use (a part of) an amount of moisture in the form of ice cubes, put some lemon juice in it.
- The less salt, the less thirsty you will be.