Fluid overload or water-wise?

Don't dehydrate yourself but let your thirst guide your water intake, suggests Dr Vineet Narang

As Hippocrates stated, “Everything in excess is opposed to nature.” Yet, when it comes to following through that, we fall short. It is believed that a steady stream of what’s essential can never hurt, but science states otherwise. Take for example water — they say that you can never have enough of it. Yet it is this excess of water that leads to a slew of impediments.

During winters, any urologist’s clinic is flooded with patients with urinary problems, mainly with regard to frequency, urgency, and sometimes incontinence. A majority of them prefer a quicker diagnosis by getting a drug prescription. Physicians often oblige without even dwelling into the most crucial factor i.e. the history of fluid intake, leading to an incomplete diagnosis that creates further complications.

By studying the intake and output of fluids, via a simple bladder diary (fluid chart), the urologist can gain information about the liquid intake and recommend measures to reduce it. It has been proved that by controlling the liquid intake, most men and women have reported an improvement in their urinary symptoms without any medication. Yet, is anyone paying heed to this obvious fact?

India falls in the unique spectrum when it comes to diagnosis and cure. Here, alternative therapy rules the roost over allopathic medicine, with people shunning the use of medicine for a more holistic or natural cure. Here, it is often believed that water has cure-all properties, trumping the most educated minds in believing that water’s goodness cannot be questioned.

One needs to set the record straight that too much water is not good for the body, especially kidney. Only 1.5 – 2 litres of liquid per day is enough for the functioning of kidneys, exceeding which, creates an imbalance in the proper functioning of the excretory system.

The deleterious effects of increased water intake (Polydipsia) are not just restricted to frequency and urgency but leading to permanent bladder dysfunction in the longer run. For the elderly, this can be fatal, as an excess intake of water leads to dilutional hyponatremia (decreased sodium in the blood) and altered sensorium. In fact, increased fluid intake is recommended only for patients who have stone-related and active UTI complications — in the measured range of 2.5 – 3 litres.

Combat excess.

Avoid drinking more than 1.5 – 2 litres /day.

Avoid rapid drinking of water.

Avoid excessive tea, coffee and carbonated drinks (sodas).

Avoid excessive fluids at night.

(The author is head, general urology,
Indian Spinal Injuries Centre)