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Water Works: How Hydration Supports IBD Health

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Staying hydrated is essential for everyone, but when you’re living with inflammatory bowel disease (IBD), proper hydration plays a critical role in managing your symptoms and overall health. 

Whether you’re dealing with Crohn’s Disease or Ulcerative Colitis, dehydration can lead to complications like fatigue, headaches, and even kidney problems. As a dietitian, I’m here to help you understand why hydration matters for IBD and how to ensure you’re getting the right amount of fluids to keep your body balanced, energized, and feeling its best.

Let’s dive into the science behind hydration and some practical tips to support your gut health.

Hydration for IBD

Hydration is about more than just quenching your thirst. For people with IBD, staying adequately hydrated helps support the body in maintaining energy, proper elimination (more so when constipation is a symptom) and promoting digestive balance. Unfortunately, IBD symptoms like diarrhea, malabsorption, and reduced appetite can make it harder for your body to retain the fluids it needs. This creates a cycle: dehydration worsens your symptoms, and those symptoms can further increase your fluid needs.

Additionally, some medications used to treat IBD, like corticosteroids, can increase water loss or change how your body manages fluid. This is why it’s important to be mindful of your hydration habits, especially during flare-ups or when experiencing digestive distress.

Signs of Dehydration in IBD

Dehydration can often be overlooked and can be common if you are experiencing either diarrhea or constipation related to your IBD. As mentioned above, decreased intake of food and fluid is often common in IBD and is another factor in dehydration.

Signs of dehydration include:

  • feeling thirsty
  • dark yellow, strong-smelling urine
  • peeing less often than usual
  • feeling dizzy or lightheaded
  • feeling tired
  • a dry mouth, lips and tongue
  • sunken eyes

How to calculate your fluid needs

A general guideline for fluid intake is to consume 25-35 mL of water per kilogram of body weight. For example: if you weigh 150 pounds, convert to kilograms and multiply by milliliters…

150 pounds/2.2 = 68.18 kg   (round to 68)

68 x 25 = 1700 mL

68 x 35 = 2380 mL

Fluid intake/day = 1700 – 2400 mL

In some cases, electrolytes may be needed for adequate hydration. Electrolytes are an essential mineral the body needs to function properly. Electrolytes help with muscle and nerve function, as well as adequate fluids in and out of the cells, and energy support. They include sodium, potassium, magnesium, calcium, and chloride.

Electrolytes

Electrolyte losses occur every day primarily through sweat and urination. However, electrolytes can also be lost from diarrhea, and vomiting. If you are dehydrated and low in electrolytes you may experience fatigue, lightheadedness, rapid pulse, muscle cramps, headaches, nausea, and may not feel like yourself.

Ultimately, it is the goal to decrease the instance why someone is having the above symptoms in the first place (ie: 10 liquid stools/day due to increased inflammation from IBD) as electrolyte drinks are generally not needed daily.

We typically recommend replacing electrolytes if you are experiencing diarrhea 4 or more times per day. This is especially important during the warm summer months, during periods of excessive sweating, or if you have had surgery to your lower colon, as in a J-pouch.

How do I know when I need electrolytes?

If you have a fever or the general rule of more than 4 loose or watery bowel movements in a day, it may be time to start including electrolytes with your hydration regimen. Because IBD is chronic, in our practice we may recommend electrolytes sooner such as more than 3 loose or watery bowel movements and if we notice low energy and signs of dehydration.

Electrolyte Formulations we like:

  • Pedialyte Clear
  • Nuun tablets
  • Cure sachets (use code IBDLOVE for 15% of products)
  • Bumble Root
  • Coconut water
  • Or you can make your own with the recipe below:
    • 2 cups pomegranate juice (or juice of choice)
    • 2 cups coconut water
    • 1/4 tsp salt

Hydration Tips for IBD Management

  1. Carry a Water Bottle: Keep a reusable water bottle with you throughout the day to remind yourself to sip regularly.
  2. Hydrate Before Meals: Drinking a glass of water about 30 minutes before meals can aid digestion.
  3. Set a Hydration Goal: Using an app or simply marking your water intake on a bottle can help you stay on track with your hydration goals. 
  4. Eat Water-Rich Foods: Foods like cucumbers, zucchini, melons, and broths not only contribute to hydration but can also offer a soothing, easy-to-digest option for your gut.
    • However, we do understand that using these foods are not always easy in IBD. Consider peeling these fruits/veggies, cooking them well, or start with smaller portions to help improve tolerance over time.
  5. Monitor Your Urine: A simple way to check your hydration status is by the color of your urine. Aim for a light straw color; darker shades are a sign you need more fluids.

Closing Thoughts

Hydration is a key, often overlooked, aspect of managing IBD. By paying attention to your body’s signals and making fluid intake a priority, you can reduce the impact of dehydration on your symptoms and support your overall well-being. 

As always, it’s important to discuss your specific fluid needs with your healthcare provider, especially if you’re dealing with a flare-up or have other medical conditions that affect hydration.

Remember, water works wonders—especially for your gut health!