Have you ever heard about ‘moderation’? Principle of ‘being in moderation’ is a good practice in life as most aspects in life need to be balanced. Anything that is too much or too less is certainly not good. That goes the same for the human body. The human body revolves around balance as each part of the system is already made to only be able to withstand or needs within the normal range as researched or studied through science. In this DoctorOnCall’s article, we will learn about fluid overload, which happens when the human body state is outside of the normal.
To understand fluid overload, it is best to understand fluid in general first. Humans are living creatures that are mainly composed of water with 75% in infants and 50 to 60% in adults is water by mass. This means that the human body is indeed high with water, making fluid in the human body a crucial part. There are several types of body fluid that are important in many systems of the body. This includes blood, lymph, urine, cerebrospinal fluid, sweat and digestive juices. In order to maintain these body fluids to work properly, it is important to maintain proper hydration. Proper hydration can ensure the body is in its healthiest state.
Fluid overload refers to the condition of the body having too much fluid. It is also called hypervolemia. Reasons being why fluid overload can be a concern is because while the body has a certain amount of fluid in normal range, body with excessive fluid can damage the body and ultimately jeopardise a person’s health. High amounts of fluid can disturb the way fluid is distributed throughout the body and negatively affect organ function.
Fluid overload can be caused by health conditions such as heart diseases or kidney diseases and excessive fluid received via intravenous fluid therapy. Fluid overload is often referred to as edema in clinical settings. Edema can occur in any tissue but commonly in the soft tissues of the upper and lower limbs (extremities).
Signs and symptoms of fluid overload can be resulted from the underlying condition contributing to the fluid overload. Main symptom of fluid overload is swelling that occurs in the face, arms or legs. Other symptoms include raised blood pressure, sudden weight gain, stomach bloating, abdominal cramps, shortness of breath and chest pain.
Diagnosing hypervolemia is based on medical history and physical examination. Doctors may ask questions regarding symptoms of possible underlying conditions leading to hypervolemia. Physical examination is done to detect the abnormality from the fluid overload. Further tests such as blood tests can give clues on the fluid level which includes the blood itself and electrolyte. These tests may also show what organ damages have already occurred that may contribute to hypervolemia. Hypervolemia that is unsure of the exact causes may require the patient to be hospitalised. This makes it easier for healthcare providers to measure fluid intake and output, along with body weight to evaluate the hypervolemia.
Hypervolemia is treated depending on the underlying cause. Treatment often includes medication to eliminate the excess fluid such as diuretics. In severe cases, doctors may recommend dialysis that removes fluid from the kidneys and paracentesis which is removing excess fluid via the abdomen. Patients may also be required to follow a certain diet to restrict dietary sodium intake. Doctors will request patients to weigh themselves daily to ensure excess fluid is expelled from the body.
Hypervolemia can be treated effectively when it is treated by a doctor and when a patient adheres to the doctor’s advice. It is important to treat hypervolemia as leaving it untreated can cause organ dysfunction. To prevent repeating episodes of fluid overload, patients can try to track their fluid intake by writing down or taking notes of what they drink or eat for the day, asking doctor advice on fluid intake guidelines and to limit sodium consumption from diet. Those who are advised to keep fluid intake low such as in patients with kidney disease on dialysis, may need to have strategies on managing thirst. This includes waiting for at least 10 minutes for the craving for fluid to pass or trying sucking on ice chips, frozen fruit or sugar-free candy to curb the thirst.
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In essence, fluid overload is a condition where the body has excess fluid. Fluid overload is also known as hypervolemia. Main symptom of fluid overload is swelling but most cases will show there is weight gain before swelling occurs. Common cause for fluid overload is the underlying health condition and excess fluid from IV therapy. Managing the underlying cause is the main treatment. Medication such as diuretic is commonly used to remove the excess fluid from the body. Dialysis and paracentesis is recommended in cases where medication is unable to remove the excess fluid. Many patients with fluid overload do recover completely with appropriate treatment.
