03 March 2004

---Increasing Fluid Intake Unwise?

"We found data to suggest that giving fluids to patients with respiratory infections may cause harm,” Chris Del Mar, of the University of Queensland in Australia, said in a report in the British Medical Journal.

According to the researchers, a large amount of a water-conserving hormone is released by the body during times of respiratory infections such as a cold or bronchitis. Drinking more could lead to fluid overload and a condition known as hyponatremia, or low concentrations of sodium which is needed for normal body functions. Furthermore, they did a journal review, interviewed medical practitioners and “could not find any randomized controlled trials comparing the impact of increased or restricted water drinking during a cold.”

Del Mar advised that “until we have this evidence, we should be cautious about universally recommending increased fluids to patients, especially those with infections of the lower respiratory tract.”

I agree that hyponatremia and fluid overload indeed are possible especially in cases of lower respiratory infection. This is also possible with elderly individuals with heart problems. I also agree that not much study has been done to prove that this treatment advice is indeed beneficial.

Doctors rely on good and sound medical judgment when they tell patients with colds to increase fluid intake. When febrile patients take antipyretics like Paracetamol to control fever and chills, they sweat a lot and lose a lot of water in the body. Advising patients to drink lots of fluids helps in replacing the lost fluids, aids in dissipating the fever, and relieves any nasal stuffiness.

In my case, instead of water, I advise patients to drink lots of fruit juices. Fruit juices are packed with precious electrolytes like sodium, potassium, and magnesium. This helps in improving the sick condition of the patient.

As a subscriber however to evidence-based medicine, I do agree that studies need to be done to either support or reject conventional treatment modes.

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