Inflammatory bowel disease (IBD): Staying hydrated

Section

What is fiber?
Why is Fiber important?
How to tolerate fiber
Tips

Tips

What is dehydration?

Good health demands proper hydration. When you lose more water than you take in, you become dehydrated, and your body cannot work as it should.

Dehydration can lead to electrolyte imbalances. Electrolytes are key minerals, notably sodium, potassium, chloride, magnesium and calcium. High or low levels can lead to life-threatening conditions.

People with inflammatory bowel disease (IBD, Crohn’s disease or ulcerative colitis) are at risk for dehydration because of large fluid losses and active inflammation.

Symptoms of dehydration

Symptoms of dehydration will depend on how much fluid you might have lost.

Mild-to-moderate dehydration

Thirst (not always reliable)
Dry mouth and tongue
Dry skin and reduced skin elasticity
Less urine production
Darker urine (can also be a side effect of medications and vitamins)
Headaches
Fatigue
Constipation (infrequent or hard-to-pass bowel movement, or hard stool)

Moderate-to-severe dehydration

Dizziness
Irritability
Confusion
Muscle cramps
Raised heart rate
Low blood pressure
Decreased urination
Sunken eyes

Risk factors for dehydration

Dehydration can affect everyone with IBD, but you may be at higher risk if you:

Have active disease.
Have a fever.
Have frequent or watery diarrhea.
Are vomiting.
Have an ileostomy or jejunostomy.
Have a J-pouch.
Have short bowel syndrome.
Have a gastrointestinal infection, such as Clostridioides difficile, or C. diff.
Are an athlete or have a physical job.

Tips for staying hydrated

These are general guidelines. See a registered dietitian nutritionist who specializes in IBD for personalized recommendations.

Work closely with your health care team and dietitian

How much fluid you need depends on how much you’ve lost. Losses vary based on ostomy output, stool, vomiting, fistulas and more. Work closely with your health care team and dietitian to determine your fluid needs.
Be mindful of physical activitiy

We lose fluid when we sweat, so be sure to replace fluids lost during exercise. A good goal for most people is to drink 24 oz of water per hour of exercise, but your dietitian can help you figure out the right amount for you.
If you have an ileostomy, reduce output with these tips
- Sip fluids between meals instead of with meals.
- Take slow, steady sips throughout the day.
- Limit sugar-sweetened beverages, such as soda, iced tea, lemonade and fruit juice. Limit sugar alcohols, such as sorbitol, xylitol and mannitol, found in food and medications.
- Use salt freely.
Consider electrolyte supplement

For most people, drinking enough water will treat mild dehydration. However, those at risk for moderate-to-severe dehydration will need an oral rehydration solution (ORS). ORS provides water, sodium and sugar in specific ratios to promote hydration.

Oral rehydration solution

You can make or buy an oral rehydration solution (ORS). Here are some recipes to make at home:

Directions: In a liter container, mix the following ingredients until salt dissolves. Throw away after 24 hours.

Salt, sugar and water

6 level teaspoons of sugar

½ level teaspoon of salt

1 liter drinking water

Coconut water base

1/2 liter coconut water
1/2 liter water
1 tablespoon fresh lemon juice
½ teaspoon salt
Fresh fruit for flavor, such as berries

Gatorade base

2 cups Gatorade
2 cups water
½ teaspoon salt

For ready-to-use products that you can buy in a store, you might try Pedialyte®, Drip Drop®, Liquid IV Hydration Multiplier® or Ceralyte®.

References

Crohn’s & Colitis Foundation

Merck Manual Healthy Living: Dehydration

Rehydration Project

Now it is time to meet with a GI-expert dietitian. To get more information about this topic, find a dietitian in your area using our Find a Health Care Provider tool.