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{{Water intoxication}}
{{Water intoxication}}
'''For patient information, click [[Water intoxication (patient information)|here]]'''


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{{CMG}}


==Overview==
{{SK}} Hyperhydration; water poisoning
'''Water intoxication''' (also known as '''<b>hyperhydration</b>''' or '''water poisoning''') is a potentially fatal disturbance in brain function that results when the normal balance of [[electrolyte]]s in the body is pushed outside of safe limits by a very rapid intake of [[water]].<ref>{{cite web|url=http://www.hhp.ufl.edu/faculty/pbird/keepingfit/ARTICLE/toomuchwater.htm|title=You Can Drink Too Much Water|accessdate=2007-01-21|last=Bird|first=Patrick J.|year=2000|publisher=University of Florida}}</ref>
Normal, healthy (both physically and nutritionally) individuals have little to worry about accidentally overconsuming water. Nearly all deaths related to water intoxication in normal individuals have resulted either from water drinking contests, in which individuals attempt to consume several gallons over the course of just a few minutes, or long bouts of intensive exercise during which time electrolytes are not properly replenished, yet massive amounts of fluid are still consumed.


==Treatment==
== [[Water intoxication overview|Overview]] ==
Mild intoxication may remain asymptomatic and require only fluid restriction.  In more severe cases, treatment consists of:
* [[Diuretic]]s to increase urination, which are most effective for excess blood volume
* [[Saline (medicine)|Saline]] given intravenously to restore [[sodium]] electrolyte levels
* [[Vasopressin]] receptor antagonists


==Prevention==
== [[Water intoxication historical perspective|Historical Perspective]] ==
Water intoxication can be prevented if a person's intake of water and electrolytes closely matches his or her losses.  The body's regulatory mechanisms provide a very generous margin of safety if the two are imbalanced, but some extreme activities (such as heavy, prolonged physical exertion), as well as disease states, can overwhelm or impair these mechanisms.  Avoid situations that provoke extreme or prolonged perspiration.  Drinking fluids that are specially balanced to replace lost electrolytes can also help to prevent intoxication.  Eating regularly can provide needed electrolytes if only normal water is available for rehydration.


[[Sports drink]]s are popular among athletes because they provide the necessary [[electrolyte]]s to support extended exercise. They help keep the body balanced and carrying the right amount of fluids. However, not all drinks advertised as sports drinks are suitable for this purpose, and professional advice should be sought for potentially risky situations such as those described above.
== [[Water intoxication pathophysiology|Pathophysiology]] ==


Note that a person's innate sense of [[thirst]] is more sensitive to overall dehydration than to changes in electrolytes.  Thus, it is possible to develop water intoxication while trying to satisfy thirst, if one drinks a great deal of water over a short period.  A dangerous drop in electrolytes, such as the hyponatremia that leads to water intoxication, will not have any effect on thirst if one is sufficiently dehydrated.
== [[Water intoxication causes|Causes]] ==


For people suffering from [[dehydration]] due to the heavy perspiration associated with heavy exertion or heat stress, drinking water to rehydrate is much more important than avoiding water intoxication, since the former is extremely common and the latter is rare.  One should never avoid drinking water under such conditions; instead, other steps should be taken to ensure that electrolytes are replaced as well, as noted above.
== [[Water intoxication differential diagnosis|Differentiating Water Intoxication from other Diseases]] ==


==Notable cases ==
== [[Water intoxication epidemiology and demographics|Epidemiology and Demographics]] ==


* On January 12, 2007, Jennifer Strange, a 28-year-old woman and a mother of 3, from Rancho Cordova, California, was found dead in her home by her mother hours after trying to win one of Nintendo's Wii game consoles in KDND 107.9 "The End" radio station's "Hold Your Wee for a Wii" contest, which involved drinking large quantities of water without urinating. However, no criminal charges were pressed.<ref>{{cite web | url=http://www.msnbc.msn.com/id/16614865/ | title=Woman dies after water-drinking contest | date=January 13 2007| publisher=MSNBC | accessdate=2007-05-10}}</ref>  The Federal Communications Commission has launched its own investigation to determine if the station violated the terms of its operating license.
== [[Water intoxication risk factors|Risk Factors]] ==
* Leah Betts<ref>{{cite web | url=http://thedea.org/hyponatremia.html | title=Hyponatremia ("Water Intoxication") | publisher=The DEA.org | accessdate=2007-05-10}}</ref> died on the 16th of November 1995 after taking an [[MDMA|ecstasy]] tablet at her 18th birthday party and subsequently drinking too much water; the case received mass media coverage throughout the United Kingdom.
* In a much-publicized case of fraternity hazing, four members of the Chi Tau (formerly Delta Sigma Phi) House at California State University, Chico pleaded guilty to forcing 21-year-old student Matthew Carrington to drink excessive amounts of [[water]] while performing calisthenics in a frigid basement as part of initiation rites on February 2, 2005.<ref>{{cite web | url=http://www.newsreview.com/chico/Content?oid=oid%3A33779 | title=Another death in the family | date=[[2005-02-10]] | first=Mark | last=Lore | publisher=Chico news & review | accessdate=2007-05-10}}</ref> He collapsed and died of [[heart failure]] due to water intoxication.
* On September 12, 1999, US Air Force basic trainee Michael J. Schindler died of [[hyperthermia|heat stroke]], severely complicated by water intoxication, two days after becoming seriously ill during a 5.8 mile march. The Air Force changed its recruit training procedures as a result.<ref>{{cite news |first=Peter|last=Grier|title=Airman's Death Brings Training Changes|url=http://www.afa.org/magazine/Jan2000/0100world.asp#anchornine|work=Aerospace World|publisher=Air Force Magazine Online|date=January, 2000|accessdate=2007-01-20}}</ref>
* New Zealand race-walker Craig Barrett collapsed during the last kilometer of the 50 km walk in the 1998 Commonwealth Games in a non-fatal case of water intoxication.
* Other notable fatalities due to water intoxication include Andy Warhol,  Anna Wood, <ref>{{cite web | url=http://www.erowid.org/chemicals/mdma/mdma_health5.shtml | title=Reasons for dispensing with the holding of an inquest | accessdate=2007-05-10}}</ref> 2002 Boston Marathon competitor Cynthia Lucero,<ref>{{cite web | url=http://www.thebostonchannel.com/newscenter5/1610699/detail.html | title=Doctors: Marathoner Died From Too Much Water | date=August 13 2002 | accessdate=2007-05-10}}</ref> and Washington, D.C. police officer James McBride.<ref>{{cite web | url=http://www.washingtonpost.com/wp-dyn/content/article/2005/08/10/AR2005081001460.html | title=District Officer Dies After Bike Ride: Over-Hydration Cited as Factor | date=August 11 2005 | publisher=Washington Post | accessdate=2007-05-10}}</ref>


==See also==
== [[Water intoxication natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==


*[[Electrolyte]]s
== Diagnosis ==
*[[Hyponatremia]]
*[[Hypernatremia]]
*[[Oral rehydration therapy]]
*[[Polydipsia]]
*[[Aquagenous Urticaria]]


==References==
[[Water intoxication history and symptoms|History and Symptoms]] | [[Water intoxication physical examination|Physical Examination]] | [[Water intoxication laboratory findings|Laboratory Findings]] | [[Water intoxication other diagnostic studies|Other Diagnostic Studies]]
{{reflist|2}}
 
== Treatment ==
 
[[Water intoxication medical therapy|Medical Therapy]] |  [[Water intoxication primary prevention|Primary Prevention]] | [[Water intoxication secondary prevention|Secondary Prevention]] | [[Water intoxication cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Water intoxication future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
 
[[Water intoxication case study one|Case #1]]
 
==Related Chapters==
 
* [[Electrolyte]]s
* [[Hyponatremia]]
* [[Hypernatremia]]
* [[Oral rehydration therapy]]
* [[Polydipsia]]
* [[Aquagenous Urticaria]]
* [[Self-induced water intoxication and schizophrenic disorders syndrome]]


[[Category:Electrolyte disturbance]]
[[Category:Electrolyte disturbance]]
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[ca:Hiperhidratació]]
[[de:Hyperhydration]]
[[es:Hiperhidratación]]
[[he:הרעלת מים]]
[[nl:Waterintoxicatie]]
[[ja:水中毒]]
[[zh:水中毒]]
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Latest revision as of 15:31, 18 December 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Hyperhydration; water poisoning

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Water Intoxication from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1

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