Diarrhea is characterized by loose, watery stools that occur more frequently than usual. It is often accompanied by abdominal cramps, bloating, nausea, and urgency to have a bowel movement. Diarrhea can be caused by infections, food intolerances, reactions to medications, and chronic conditions like irritable bowel syndrome. While diarrhea usually resolves on its own within a few days, it is important to stay hydrated to prevent dehydration, which can be dangerous. This article will explore whether not drinking water can stop diarrhea.
Can dehydration stop diarrhea?
When you have diarrhea, your intestines are expelling fluid at a rapid rate, leading to the watery stool characteristic of diarrhea. So you may think that not drinking any fluids could lead to dehydration which could then “dry up” the diarrhea. However, research shows that dehydration does not stop diarrhea and can actually make it worse.
One reason is that dehydration causes the intestinal cells to release more electrolytes and water into the intestinal tract in an attempt to dilute the hyperosmotic environment. This draws even more fluid into the intestines, leading to further watery stools. Additionally, certain toxins and compounds that cause diarrhea work by stimulating intestinal secretion. Not drinking water will not stop this secreted fluid from causing diarrhea.
Studies have found that dehydrated children with diarrhea who are not given rehydration therapy end up having diarrhea for a longer duration than those who receive fluids. This shows that dehydration prolongs diarrhea rather than stopping it.
Clinical evidence
Multiple clinical studies have compared the effects of oral rehydration solution (ORS) versus restricted fluid intake in children with diarrhea. ORS contains water, salts and sugar to promote absorption and replenish lost electrolytes. Children given ORS consistently had shorter durations of diarrhea, fewer stools, less vomiting, and required less IV fluids compared to restricted fluid intake. This directly demonstrates that providing hydration shortens diarrhea, while dehydration prolongs it.
Mechanism of diarrhea
The pathophysiology of diarrhea also explains why dehydration does not halt it. The main mechanisms are:
- Increased secretion: Bacteria, viruses, toxins directly stimulate secretion of electrolytes and water into the intestinal lumen.
- Decreased absorption: Damage to intestinal villi results in impaired fluid absorption.
- Increased motility: Accelerated intestinal contractions propel contents faster through the colon.
As you can see, none of these mechanisms are reversed by dehydration. In fact, they are worsened due to the release of electrolytes and water from damaged intestinal cells in an attempt to dilute the hyperosmolar environment.
Dangers of dehydration
Not only is withholding hydration ineffective at stopping diarrhea, it can be downright dangerous. Dehydration occurs when the loss of fluids and electrolytes exceeds intake. Diarrhea results in significant losses of water, sodium, potassium and other elements from the body. If these are not adequately replaced, dehydration can occur.
Signs of dehydration include:
- Thirst
- Less frequent urination
- Dark yellow urine
- Fatigue
- Dry mouth
- Dizziness upon standing
- Low blood pressure
Severe dehydration can lead to organ damage, seizures, coma and even death. Dehydration is especially dangerous in infants, young children and the elderly.
Complications of dehydration
Some potential complications of dehydration include:
- Electrolyte imbalances – depleting salts like sodium, potassium and chloride.
- Kidney stones – concentrated urine allows crystals to form.
- Urinary tract infections – concentrated urine favors bacterial growth.
- Seizures – from electrolyte abnormalities and hypotension.
- Shock – critically low blood volume impairs circulation.
- Death – most serious complication from very severe dehydration.
Vulnerable groups
The following groups are at highest risk for dehydration and its complications:
- Infants and young children
- Elderly adults
- People with chronic diseases like diabetes or kidney failure
- Individuals taking medications that increase fluid loss like diuretics
- Athletes and outdoor workers in hot climates
Care should be taken to prevent dehydration in these populations when diarrhea occurs.
Importance of hydration in diarrhea
Maintaining hydration is critical when you have diarrhea. Here’s why:
- Prevents dehydration – Fluid intake replaces losses from diarrhea.
- Shortens duration – Hydration provides liquid to absorb and decreases stimulation of intestinal secretion.
- Allows medications to work – Oral rehydration enables oral antibiotics and anti-diarrheals to be absorbed.
- Avoids hospitalization – Dehydration is a common cause of hospitalization for diarrhea. Hydration can prevent this.
Oral rehydration therapy
The World Health Organization and pediatricians recommend oral rehydration solution as the first-line treatment for dehydration from diarrhea. ORS contains the optimal blend of water, salts and sugar to promote absorption in the small intestine even during diarrhea:
- Water – replaces fluid losses
- Sodium – absorbs water through osmosis
- Potassium – needed for muscle and nerve function
- Chloride – balances electrolytes
- Citrate or bicarbonate – counteracts acidosis
- Glucose – provides ready energy
By providing essential electrolytes and sugars, ORS enhances the absorption of water even with impaired intestinal cells. This maximizes hydration and minimizes fluid loss in diarrhea.
Importance in children
Diarrhea is a leading cause of dehydration and death in children worldwide. ORS has been credited with saving millions of young lives in developing countries. It allows fluid replacement at home without the need for IV fluids. Caregivers should provide children with frequent small volumes of ORS at the first sign of diarrhea.
Drinking water
While ORS is recommended, plain water can also prevent and treat dehydration from diarrhea. Water does not contain salts and sugar for absorption like ORS, but simply provides fluid volume to counter losses. Drinking water is especially important when diarrhea is prolonged and electrolyte blood levels are normal.
Foods and drinks to avoid
Although hydration is important in diarrhea, some fluids may make symptoms worse. These should be avoided:
- Alcohol – further dehydrates and irritates the gut.
- Caffeinated drinks – stimulate motility and secretion.
- Dairy – lactose intolerance may exist.
- Fatty foods – difficult to digest.
- Very sugary drinks – can cause osmotic diarrhea.
- Juices high in fructose – can malabsorb and irritate.
The BRAT diet refers to bananas, rice, applesauce and toast – bland binding foods that are better tolerated. But hydration should come first when managing diarrhea.
Avoiding solid foods
While solids are not recommended in severe diarrhea, completely avoiding foods and only drinking clear liquids is no longer routinely advised. New evidence shows that:
- Early refeeding with age-appropriate solids shortens duration of diarrhea in children.
- A normal diet is well tolerated in adults within 12-24 hours of starting ORS.
- Continued feeding provides nutrients and energy to heal the intestines.
Therefore, advancing slowly from clear liquids to bland foods is reasonable for most individuals with mild diarrhea. But ORS and water should be given first and foremost.
Conclusions
In summary, research clearly demonstrates that withholding hydration does not resolve diarrhea. In fact, it leads to dehydration which prolongs diarrhea and causes dangerous complications, especially in high risk groups. Maintaining hydration with oral rehydration solutions and water is imperative when you have diarrhea to replace fluid losses. While certain foods and drinks may irritate, completely avoiding solids is no longer recommended. Checking for signs of dehydration and giving ORS and water at the first sign of diarrhea can prevent hospitalization and save lives worldwide.