Your body depends on water to survive. Every cell, tissue, and organ in your body needs water to work properly. For example, your body uses water to maintain its temperature, remove waste, and lubricate your joints. Good hydration is important for overall good health.

Making sure you get enough water every day is an important step in maintaining your health.

Path to improved health

Most people have been told they should drink 6 to 8, 8-ounce glasses of water each day. That’s a reasonable goal. However, different people need different amounts of water to stay hydrated. Most healthy people can stay well hydrated by drinking water and other fluids whenever they feel thirsty. For some people, fewer than 8 glasses may be enough. Other people may need more.

While plain water is best for staying hydrated, other drinks and foods can help, too. Water can be found in fruits and vegetables (for example, watermelon, tomatoes, and lettuce), and in soup broths. Fruit and vegetable juices, milk, and herbal teas add to the amount of water you get each day. Just make sure to limit sugary drinks that are high in calories.

Hydration and caffeine

Even some caffeinated drinks (for example, coffee, tea, and soda) can contribute a little to your daily water intake. A moderate amount of caffeine (400 milligrams) isn’t harmful for most people. Here are the caffeine amounts found in popular drinks:

• 12 ounces of soda: 30 to 50 milligrams
• 8 ounces of green or black tea: 30 to 50 milligrams
• 8 ounces black coffee: 80 to 100 milligrams
• 8-ounce energy drink: 45 to 80 milligrams

However, it’s best to limit caffeinated drinks. Caffeine will cause you to urinate more frequently. This can make it difficult to stay hydrated. It can also make you feel anxious or jittery.

Sports drinks can be helpful if you’re planning on exercising at higher-than-normal levels for more than an hour. They contain carbohydrates and electrolytes that can increase your energy. They help your body absorb water. However, some sports drinks are high in calories from added sugar. They also may contain high levels of sodium (salt). Check the serving size on the label. One bottle usually contains more than one serving. Some sports drinks contain caffeine, too. Remember that a safe amount of caffeine to consume each day is no more than 400 milligrams.

Energy drinks are not the same as sports drinks. Energy drinks usually contain large amounts of caffeine. Also, they contain ingredients that overstimulate you (guarana, ginseng, or taurine). These are things your body doesn’t need. Most of these drinks are also high in added sugar. According to doctors, children and teens should not have energy drinks. Because these drinks have high amounts of caffeine, they do not offer good hydration.

If staying hydrated is difficult for you, here are some tips that can help:

• Keep a bottle of water with you during the day. To reduce your costs, carry a reusable water bottle and fill it with tap water.
• If you don’t like the taste of plain water, try adding a slice of lemon or lime to your drink.
• Drink water before, during, and after a workout.
• When you’re feeling hungry, drink water. Thirst is often confused with hunger. True hunger will not be satisfied by drinking water. Drinking water may also contribute to a healthy weight-loss plan. Some research suggests that drinking water can help you feel full.
• If you have trouble remembering to drink water, drink on a schedule. For example, drink water when you wake up, at breakfast, lunch, and dinner, and when you go to bed. Or drink a small glass of water at the beginning of each hour.
• Drink water when you go to a restaurant. It will keep you hydrated, and it’s free.

Things to consider

If you don’t drink enough water, you may become dehydrated. This means your body doesn’t have enough fluid to operate properly.

Your urine can be an indicator if you’re dehydrated. If it’s colorless or light yellow, you’re well hydrated. If your urine is a dark yellow or amber color, you may be dehydrated.

There are other signs that can signal you may be dehydrated. They include:

• Little or no urine
• Urine that is darker than usual
• Dry mouth
• Sleepiness or fatigue
• Extreme thirst
• Headache
• Confusion
• Dizziness or lightheadedness
• No tears when crying

Some people are at higher risk of dehydration. They include people who:

Exercise at a high intensity (or in hot weather) for too long

Have certain medical conditions (kidney stones, bladder infection)

Are sick (fever, vomiting, diarrhea)

Are pregnant or breastfeeding

Are trying to lose weight

Can’t get enough fluids during the day

Are on medications that contribute to dehydration

Older adults are also at higher risk. As you get older, your brain may not be able to sense dehydration. It doesn’t send signals for thirst.

Note that water makes up more than half of your body weight. You lose water each day when you go to the bathroom, sweat, and even when you breathe. You lose water even faster when the weather is hot, when you’re physically active, or if you have a fever. Vomiting and diarrhea can also lead to rapid water loss. Be sure to actively drink plenty of water to avoid becoming dehydrated.

Questions to ask your doctor

• I don’t like water. What’s the next best thing to keep me hydrated?
• What can I add to water to make it taste better?
• What if I can’t consume as many fluids as doctors recommend?
• What does it mean if I drink a lot of fluids but don’t urinate often?
• How does drinking alcohol affect hydration?
• Am I on any medications that contribute to dehydration?

Resources

Centers for Disease Control and Prevention: Water & Nutrition

National Institutes of Health, MedlinePlus: Dehydration

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Patients who can’t swallow because of a medical problem still need nutrition and fluids. Getting these other than by mouth is called artificial hydration and nutrition.

Artificial hydration and nutrition works for many types of patients. Doctors use it for patients who have temporary medical problems and have lost fluids through vomiting, sweating, or diarrhea. They also may provide artificial hydration and nutrition when someone has an advanced, life-threatening illness and is dying.

Why do our bodies need fluid and nutrition?

Our bodies are made mostly of water. Almost 60% of our body weight comes from water. In order to be healthy, the body needs water just as it needs food. We lose water every day in 2 ways:

• By going to the bathroom (about 45 ounces a day)
• By sweating and breathing (at least 21 ounces a day)

Our bodies get nutrients from the food we eat. These nutrients give us energy and help our bodies work properly.

We have to eat food and drink fluids every day to get the amount of water and nutrients our bodies need.

Path to improved health

There are 2 ways to replace fluids in someone who needs them. The first way is to put the fluid right into a vein. This is called intravenous (IV) fluid replacement. The other way is to put the fluid under the skin. This is called hypodermoclysis, or subcutaneous, fluid replacement.

Another method of artificial nutrition and hydration is through a plastic tube called a nasogastric tube (also called an NG tube). This tube is put through the nose, down the throat, and into the stomach. It can only be left in for a short time, usually 1 to 4 weeks. If a tube has to be in for longer than 4 weeks, a different kind of feeding tube may be used. It’s placed into the wall of the stomach (also called a PEG tube or g-tube).

With IV fluid replacement and feeding tubes, doctors and nurses need to watch the person very closely in a hospital. But a family member or another caregiver can do hypodermoclysis at home. A doctor or nurse can show them how to do it.

How does hypodermoclysis work?

A bag of fluid is connected to a long needle by a plastic tube. The needle is put under the skin and taped in place, usually on the chest, abdomen, or thighs. The fluid drips from the bag, through the tube and needle, and into the skin. The skin then absorbs the fluid into the body.

A small window, or “drip chamber,” in the tube shows how fast the fluid is dripping. A roller clamp controls the speed of the drip. Your doctor will decide how fast the fluid should drip. Your doctor will show you how to control the drip and tell you when to check it at home. You can ask your doctor for help if you have questions or problems. A nurse or doctor should replace the needle every 4 to 7 days so the flesh around the needle does not become infected.

What are the common problems with hypodermoclysis and what should I do?

Most of the time, hypodermoclysis is safe. Sometimes, though, problems do occur. Here are a few things that might happen during hypodermoclysis:

• The speed of the drip changes or the drip stops. Your doctor will show you how to control the flow rate by rolling the roller clamp.
• The site where the needle is inserted will swell. If you gently rub the skin there, the fluid will soak in better. Your doctor will show you how. Call your doctor for help if the swelling continues or does not get better.
• The site where the needle is inserted becomes painful. Check the skin for redness. Tell your doctor if the skin is red. It may be time to find a different place to insert the needle.
• Blood collects in the tube. This means the needle has gone into a vein. Call your doctor if this happens.
• The person has trouble breathing or is feeling much worse. If this is the case, call your doctor.

What are the benefits of artificial hydration and nutrition?

A person who has a temporary illness and can’t swallow needs nutrients and water. Artificial hydration and nutrition can help prevent dehydration and help the patient recover from their illness.

For a patient who has an advanced life-threatening illness and who is dying, artificial hydration and nutrition may not provide many benefits. Artificial hydration and nutrition in these patients may make the patient live a little longer, but not always.

Things to consider

IV fluid replacement and hypodermoclysis can cause infection at the site of the IV or hypodermoclysis needle. Blood clots can form in the vein and cause pain and swelling. Fluid overload and electrolyte imbalances are also possible side effects.

There is always a risk when someone is fed through a tube. Liquid might enter the lungs. This can cause coughing and pneumonia. Feeding tubes are often uncomfortable for the conscious patient. They can become plugged up, causing pain, nausea, and vomiting. Feeding tubes may also cause infections. Sometimes, patients may need to be physically restrained or sedated to keep them from pulling out the feeding tube.

What happens if artificial hydration or nutrition are not given?

People who don’t receive any food or fluids will eventually fall into a deep sleep (coma) and usually die in 1 to 3 weeks.

How do we decide whether to use artificial hydration and nutrition?

Talk with your doctor about the risks and benefits of artificial hydration and nutrition. Each situation is different. Your doctor can help you make the decision that is right for the patient and family.

Questions for your doctor

• Is artificial nutrition and hydration part of life support?
• How long can a patient be on artificial nutrition and hydration?
• Should I make artificial nutrition and hydration part of my advance directive?
• Is it considered suicide to refuse artificial nutrition and hydration?
• What does the law say about artificial nutrition and hydration?

Resources

National Institutes of Health, MedlinePlus: Nutritional Support

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