Physicians have generally advised individuals to drink a lot of water if sick. A new case study reports the dangers of consuming too much water and shows the need for more study to support this standard advice.
For years, the major medical advice in case of flu or respiratory infections has been to consume a lot of fluids.
Theoretically, this is regarded good advice; while in a cold, the body releases more liquids via the nose or may be running a fever, which could result in more fluid loss.
In the case of infections in general, consuming more water is thought to assist with intravascular volume loss, enhanced vascular permeability, along with replace the fluids lost in fever and vomiting.
The medical advice to consume plenty of water also rests on the assumption that water intake is harmless.
A new case report informs physicians and patients that proof for the advantages of drinking plenty of water is limited, and, in fact, drinking plenty water can be dangerous.
Water intoxication in a woman with a simple UTI
A new paper, presented in BMJ Case Reports, details the case of a 59-year old woman who consumed too much water as a outcome of her urinary tract infection (UTI).
The woman began to feel the symptoms of a repeating UTI, which had flared up various times in her life formerly.
In the case of UTIs, consuming more water than regular has been shown to temporarily decrease the number of bacteria in urine, but the causes for this remain not clear.
Remembering the doctor’s suggestions of drinking half a pint of water every 30 minutes, the woman drank various liters of water that day, but her UTI symptoms worsened. As a outcome, she presented herself to the emergency department at King’s College Hospital in the United Kingdom with symptoms of lower abdominal pain and dysuria.
Urine analysis confirmed a UTI, but the sufferer was otherwise healthy. She had no medical history besides a recurring UTI, did not smoke or take any medicine or recreational drugs, had no allergies, and was a moderate alcohol drinker.
In the emergency department, the woman was recommended antibiotics and analgesics for her UTI. However, she shortly started displaying new symptoms, like as shakiness and tremor, vomiting, and speech complications.
The patient’s Glasgow Coma Scale was 15 – she had an attention deficit, was hesitant in speech, and had problems finding her words. Otherwise, the patient was healthy.
Because of her speech impairment, doctors considered the possibility of a stroke. Blood tests and a computed tomography (CT) scan quickly revealed this was not the case. However, blood tests showed signs of hyponatremia.
Too much water intake may lead to acute hyponatremia
Hyponatremia is a medical situation caused by unusually low levels of sodium – lower than 134 millimoles per liter.
Acute hyponatremia, which develops in wit in 2days, is regarded an emergency, as it can have fatal neurological outcomes. Seriously low levels of sodium can result in cerebral edema with enhanced levels of intracranial pressure and brain herniation. This results in seizures, coma, and death.
The mortality rate for hyponatremia cases is 17.9 %.
In the case report, the sufferer’s sodium level was 123 millimoles per liter. The fatality rate for sufferers with sodium levels below than 125 millimoles per liter is almost 30 %.
Water intoxication, which can result in fatal hyponatremia, has been reported in endurance exercise, in the use of the drug MDMA, and in psychogenic polydipsia – a condition where the sufferer drinks large amount of water compulsively, generally as a outcome of a psychiatric problem.
After having her water consumption limited to 1 liter per day, the patient’s situation enhanced considerably in the next 24 hours. Sodium levels were returning to normal, and the patient was discharged.
Time to question the medical advice to drink a lot of water
The authors of the case study point out that water intoxication, which can result in hyponatremia, is a rare incident among individuals with normal physiology. If a sufferer has regular renal function, it is challenging to drink more water than the body can excrete.
However, if the levels of anti-diuretic hormones are elevated, as is the case in some conditions, this can decrease the excretion of water. In these cases, the authors ask, how good is the medical advice to drink plenty of liquids?
The case of the 59-year-old woman is similar to a formerly reported case, where a healthy young female consumed too much water while experiencing gastroenteritis. As a outcome, she developed acute hyponatremia and died.
In both circumstances, the sufferers followed the doctor’s advice, although they overdid the suggested intake of water. As the authors point out.
“Collectively these two cases spotlight the significance of clear history taking, which includes a collateral, prompt investigation and correction of electrolyte imbalance and, also the require to qualify our advice about water intake in simple infective illness.”