How to deal with dehydration when you have IBD

Are you finding it difficult to stay hydrated due to the signs and symptoms of inflammatory bowel disease (IBD)? Diarrhea can lead to dehydration even in healthy adults, which can be a particular problem when IBD causes chronic diarrhea. People with Crohn’s disease and ulcerative colitis also sometimes have surgery to treat their disease, which may include removing part or all of the large intestine. The large intestine is where most water is absorbed, and when some or all of it is missing, the body may absorb less water. This is why hydration is an area of ​​particular concern for those who have an ileostomy or who have undergone j-pouch surgery (ileal pouch-anal anastomosis or IPAA). Dehydration is the leading cause of readmission after ileostomy.

The origins of sports and energy drinks

Many people use sports drinks as a source of hydration. Several different groups have developed drinks designed to provide hydration and energy before, during, and after exercise. The most famous of these was originally developed for athletes who may lose a lot of water through sweating, especially in hot weather. At the request of the university’s assistant football coach, Dr. Robert Cade of the University of Florida led a team that initially developed a drink containing electrolytes and carbohydrates. Soccer teams have had successful seasons while using the drink, and other colleges are starting to demand it. This was certainly the beginning of the sports drink Gatorade.

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Over time, manufacturers started adding other ingredients to their drinks, including stimulants like caffeine, to create energy drinks. Most energy and sports drinks also contain artificial colors and sweeteners.

Sports drinks may not be the answer to dehydration

Some aspects of sports drinks and energy drinks are less than perfect for people with IBD who need fluid and electrolyte replacement. The first is that they don’t actually provide the right mix of nutrients: most don’t have enough electrolytes. The second is that some brands contain unwanted things that make them taste better (sugar or artificial sweeteners), look colorful (artificial colors), and provide a burst of energy (caffeine).

The World Health Organization has developed an oral rehydration salt (ORS) solution that is used worldwide, especially in areas where severe dehydration leads to illness and death. Rehydration using a special combination of salt and water is called oral rehydration therapy (ORT), and it can save lives in parts of the world where diarrheal disease is the leading cause of death among children. ORS is available in Western pharmacies, hospital supply stores, and sometimes sporting goods stores with first aid kits. There are also ORS recipes that can be made at home. ORS is usually fairly inexpensive, but talk to your doctor before buying or rehydrating at home.

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How can I rehydrate patients with IBD?

How can someone with a j-bag, ileostomy, or IBD rehydrate at home if they don’t have an ORS supply on hand (though it’s not a bad idea to keep some in emergency supplies)? According to the University of Michigan IBD team, rehydration is best done in combination with something that most people with IBD probably already have at home. Experts at the University of Michigan suggest sports drinks are just the beginning.

To stay hydrated, they recommend eating and drinking items from this “recipe” designed to mimic ORT:

  • 1 liter sports drink
  • One of the following:
    1.6 bananas
  • 3 1/2 tablets of 650 mg sodium bicarbonate (or 7 325 mg tablets)

The United Ostomy Association also has formulas that can be used to replace electrolytes and fluids. Here’s a suggested homemade electrolyte drink:

  • 1 teaspoon salt
  • 1 teaspoon baking soda
  • 1 teaspoon white caro syrup
  • 1 6-ounce can frozen orange juice
  • Add water to make a quart and mix well

What to do if you are dehydrated

Mild cases of dehydration can usually be managed at home. Severe cases of dehydration may require treatment by a doctor or hospital. For severe dehydration with symptoms of confusion, dizziness, or fainting, call 911. If you have more questions about how to avoid dehydration or what to eat or drink while dehydrated, talk to your doctor.

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Frequently Asked Questions

  • Is Gatorade good for dehydration?

    In some cases, Gatorade may help with dehydration. A study found that Gatorade can help with dehydration while participating in sports, but the drink still falls short of the needs of athletes. However, artificial sweeteners and artificial ingredients used to make beverages should be kept in mind as consuming too much can have negative health effects.

  • What diseases can cause dehydration?

    Conditions that cause dehydration can include inflammatory bowel disease (IBD), Crohn’s disease, diabetes, gastroenteritis, alcoholism, or any other condition that causes severe diarrhea or fluid loss.

  • Can energy drinks make you dehydrated?

    Certain energy drinks can dehydrate you. This is due to stimulants like caffeine, which can also cause anxiety, digestive problems, and sleep quality. The amount of caffeine varies from one energy drink to another.

  • What are the symptoms of ileostomy dehydration?

    Signs or symptoms of ileostomy dehydration include dark urine, dry mouth, fatigue, rapid weight loss, increased thirst, muscle cramps, stomach cramps, and diarrhea. If you suspect you’re dehydrated, try pinching the skin on your forearm. If the skin remains upright for a few seconds, this could be a sign of dehydration.