Abdominal pain in active adults can be caused by this one common condition
It is estimated that 75% of Americans are dehydrated. For a country that has ample access to water, it seems difficult to understand. Yet, because of our busy lifestyles it is easy to forget one of our basic needs, which is remaining adequately hydrated. It is an epidemic which effects young and old alike.
The elderly are at risk for dehydration due to their reduced ability to perceive thirst. Athletes however, are also at risk due to multifaceted reasons. Unless you prepare for your workout both before and after, you risk dehydration and the plethora of symptoms involved.
In an attempt to become a healthier and stronger individual, my twenty year old son has restarted a workout routine. He has become very good at rotating cardio workouts and strength training. He will add protein shakes to his routine however as evidenced by his recent trip to the E.R. he could a reminder to hydrate before and after his workouts. Spending the night in the E.R. with severe abdominal pain was not how anyone would like to spend their time. It is a reminder that being subjected to several phlebotomy attempts to obtain lab values, a CT scan of the abdomen and numerous bags of intravenous fluids could have been avoided.
How our cooling system works
When we exercise, our body burns nutrients that release heat. This in turn raises our body core temperature. In response our body will divert blood to capillaries underneath the skin’s surface to help reduce heat. At the same time, our lungs are expelling heat through the process of heavy breathing. However the most efficient way our body cools down is through the production and excretion of sweat. It is through the evaporation of sweat that our body cools. It is a vicious cycle because our body requires adequate hydration in order to sweat and through the process of sweating we are losing fluids.
Symptoms of body fluid loss
As our body starts to lose hydration, symptoms begin to appear. Here is what happens as our body attempts to compensate.
0% water lost – No symptoms
1% water lost – Heat regulation becomes altered with performance declining.
2% water lost – Further decrease in heat regulation and increased thirst
3% water lost – Worsening performance
4% water lost – Exercise performance cut by as much as 30%.
5% water lost – Headaches, irritability and fatigue starts.
6% water lost – Severe loss of heat regulation and weakness.
7% water lost – Risk of physical collapse
10% water lost – Coma
11% water lost – High risk for death.
[Nutrition for Cyclists, Grandjean & Ruud, Clinics in Sports Med. Vol 13(1);235-246. Jan 1994]
A study was conducted at Combined Military Hospital, Malir Cantonment Karachi between 2000 and 2002. The purpose was to investigate the correlation between dehydration and the cause of acute abdominal pain. All the patients reported pains severe enough to seek treatment in an outpatient setting or E.R. They were predominantly male and in their 20s or thirties. All were suffering from dehydration and diagnosed as having an 'acute abdomen'. In addition 95.6% had a headache, 91.2% had back pain and 42.6% had vomiting. Nearly 84% required administration of intravenous fluid administration. They concluded that dehydration could be seen as a cause of severe abdominal pain and that there is a need to educate about the benefits of adequate fluid intake.
Dehydration and abdominal pain
Dehydration can have a role in abdominal pains that occur because of exercise. This is due to the rate at which fluids are absorbed by the stomach versus the volume of fluids lost to sweat produced during exercise. It is not a matter of chugging bottle after bottle of water or Gatorade either. The body can only absorb around 800 cc of fluids per hour. This amounts to a little less that a Liter. In comparison during intensive exercise you can lose almost 2 Liters an hour. It is easy to see how quickly you can become dehydrated. Eating salty snacks or caffeinated drinks around the time of exercise will only make matters worse.
Exercise induced abdominal pain can be treated effectively with rest and rehydration. It may be prevented entirely by eating a light meal that is high in carbohydrates an hour before exercise and drinking water or Gatorade 20 to 30 minutes before exercise begins. The carbohydrates can effectively provide energy without stressing the GI tract and the fluids helps to slow dehydration.
Take home message
It is always good to exercise and be as active as your body will allow. As in everything however it should be done in moderation and dehydration prevention should be a priority.