Water Intoxication Syndrome Explained

The human body consists of 75% of water during infancy, and as we grow old, the water percentage in our body declines to 45%. With this amount of water present in the body, a person would think that a few more liters of water in the body will have no negative effects on the body. However, the homeostatic balance of our body is slightly more delicate and complicated as compared to what we think. Excess of water in the body can lead to Hyponatremia, also known as hyper-hydration and water intoxication.

Hyponatremia (Hyper-Hydration or Water Intoxication)

Hyponatremia or hyper-hydration is a body’s state where the water level in the body is disturbed due to excess water retention, and this imbalance in the water level of our body affects our health and may cause stroke, coma, and death in severe cases.

The process of water intoxication

The term Hyponatremia is derived from its Latin and Greek roots and translates to insufficient salt in the blood. In this condition, the excess level of water present in the body causes the dilution of salt and electrolytes to a point where they are not functional. The loss of salt and electrolytes in the body disrupts the normal functioning of our kidneys and causes severe physical problems. There are different types of Hyponatremia:

• Chronic Hyponatremia: when the blood sodium levels drop over some time.
• Acute Hyponatremia: when the blood sodium levels drop over a shorter time and have more severe symptoms.

Factors and Conditions Responsible for Hyponatremia (Water Intoxication)

The process of detecting hyponatremia is hard as compared to other diseases. The biological reason behind this disease is based on the abnormal retention of water because of several neurological and gastrointestinal problems. The excess amount of water present in the body dilutes the electrolytes and salt to a weak concentration. The cells in the body are forced to absorb this water to restore the concentration of electrolytes. The inflammation of cells in the body continues till the time the swelling reaches the brain cells, which causes cerebral edema resulting in strokes, coma, or death.

While the main reason behind this condition is the over-retention of water, multiple mental and physical factors can also lead to its occurrence. The biggest risk of water intoxication is among people who are suffering from depression and schizophrenia. People suffering from depression often have recurring suicidal thoughts and they might consider over-consumption of water. Schizophrenic patients, on the other hand, are at a higher risk of getting affected by this condition because of their inability to think and react clearly. A person is likely to get affected by this disease if they are taking any medications like antidepressants, diuretics, etc. These medicines decrease the sodium level in the blood while they are being used to treat other symptoms of a disease.

Some other conditions that might lead to water intoxication are:

• Earlier, athletes were asked to not drink water during their workout sessions as it would hamper their performance in the sport. However, people now have started consuming water during their workout sessions but drinking water after prolonger workout sessions will replete water without balancing the electrolytes in the body causing water intoxication.
  

  Athlete drinking water during a workout session

• Any act of torture in prison is condemned by the government, but there are times when the officers would use the method of excessive water ingestion to torture a prisoner.

• Psychogenic polydipsia or self-induced water intoxication is a condition faced by people who are suffering from depression, and these people face this persistent sensation of thirst.

Some medical conditions and medicines also cause overhydration in the body by making your body hold more fluids. These are:

• liver disease
• congestive heart failure
• kidney problems
• uncontrolled diabetes
• nonsteroidal anti-inflammatory drugs
• syndrome of inappropriate antidiuretic hormone

Some medicines and conditions that increase the water intake by making you thirsty:

• schizophrenia
• MDMA (also known as ecstasy)
• diuretics
• antipsychotic drugs

Detection of Water Intoxication

While the disease is not very common, detecting water intoxication in its early stage is hard as the symptoms of this disease include headaches, nausea, confusion, and vomiting, which can be linked to several other diseases. The symptoms of water intoxication are quite similar to those of alcohol intoxication, especially nausea and inability to think clearly.

Bloating after drinking water

The first symptom of water intoxication is always nausea as we face a problem in holding more than the average amount of water. After this, a person faces slurred speech, weakness, headache, bloating, and hallucination as the body fails to excrete the excess amount of water. At this point, the person starts to lose his ability to think clearly, and the person starts drinking more water in a crazed state. After this, the excess water in the body starts affecting the brain cells causing swelling in them. This condition is known as cerebral edema. The human skull acts as a cover for the brain, and as the swelling increases, it increases the overall pressure on the brain. Due to the increased pressure, the body soon shuts down in a coma or experiences severe seizures that eventually lead to death.

Diagnosis of the condition

While it is hard to discover this condition in its early stages, the diagnosis of the condition is done by monitoring the level of body fluids to understand the disruption caused in the body. Apart from this, a patient’s medical history is also examined to look for any instances of prolonged vomiting, excessive sweating, previous blood tests, and urine tests. The treatment for this condition depends on the amount of excess water a person has consumed as it would be important to figure out the imbalance in the body and what all body systems have begun to fail.

Treatment of Water Intoxication

The goals of the treatment of water intoxication are:

• Prevent brain herniation
• Prevent further decline in sodium levels in the body
• Cure the symptoms of hyponatremia

There are several ways in which this condition can be treated. In cases of early detection, treatment is done using IV fluid that contains electrolytes as it restores the normal salt concentration in the blood. This can also be treated by consuming salty foods. Treatment for more severe cases is done by using vasopressin receptor antagonists that stop the release of vasopressin from the posterior pituitary gland. With this, the amount of vasopressin impacting the kidneys is reduced, helping the body to conserve less water and allowing the excess water to be naturally excreted.

Asymptomatic Cases: For asymptomatic patients, the treatment is initiated by giving a 3 percent saline 50 ml bolus so that the concentration of sodium remains steady in the body. Further, the patient must be monitored for signs and symptoms to measure the serum sodium concentration every couple of hours.

Symptomatic Cases: Patients who are acutely hyponatremic and complain about increased intracranial pressure should begin their treatment with a 3 percent saline 100 ml bolus, with 2 additional 100ml doses, where each bolus is infused after every 10 minutes, in case the symptoms persist.

Noticeable Cases of Hyponatremia/Water Intoxication

• In 1991, the American artist, producer, and film director Andy Warhol died due to water intoxication. His family filed a case against the hospital where Andy went to get his gallbladder removed. However, after the surgery, he slipped into a coma and died unattended because his doctors overloaded him with fluids. An autopsy report stated that Andy’s weight was 58 kgs when admitted, but the report stated his weight was 68 kgs after his death.

• In 2003, the British actor Anthony Andrews had to visit a hospital for his role in a musical. Anthony was playing the role of Henry Higgins in the revival of the musical ‘My Fair Lady.’ Anthony would drink up to eight liters of water during the rehearsals in a day, which eventually took a toll on him when he was unconscious and in the intensive care unit (ICU) for three days.

• In 2005, a student of Chico State University, California, died when he was asked to perform a fraternity hazing ritual where he was forced to drink a huge amount of water.

• In January 2007, The KDND radio, a California-based radio station in their morning show, the Morning Rave, started an on-air contest titled ‘Hold your Wee for a Wii,’ where contestants were supposed to drink as much water as they could with no urinating breaks allowed. Jennifer Strange, a resident drank almost 2 gallons (7.6 liters) of water in an attempt to win a Nintendo Wii for her kids. However, Jennifer started feeling nauseous and had a severe headache, and she died before she got proper medical attention. Later, KDND’s parent company Entercom Sacremento LLC was asked to pay $16 million in damages to Jerry’s family.

• In March 2020, Zachary Sabin, an 11-year-old from Colorado, lost his life after his parents forced him to drink a lot of water in just a few hours. His parents thought that his urine was very dark, and they forced him to drink a lot of water to hydrate himself, but they ended up filling him up with water.

Facts/Trivia

• Over the years, many health experts have recommended that on average, a person should consume at least eight glasses of water or almost 2 liters of water throughout the day.
  
  

• The average water consumption recommended by The U.S. National Academies of Sciences, Engineering, and Medicine says that women should have 2.7 liters of water per day and men should have 3.7 liters of water per day.

• Many studies have suggested that drinking water also helps with weight loss as our body often confuses thirst with hunger, and we end up overeating. Several fitness coaches recommend that drinking 500ml water before each meal will help a person to minimize their portion intake and lead to weight loss.

• Drinking plenty of water helps in dealing with several health problems like constipation, urinary tract infection, kidney stones, skin hydration, etc.