Guest Blog By: Dr. Lillian Craggs-Dino, DHA, RDN, LDN Dehydration is one of the most common but preventable causes of readmission to the hospital after metabolic and bariatric surgery (MBS). A study with 99 post-operative patients identified that almost 25% were readmitted for dehydration. (1) This blog discusses the importance of maintaining daily fluid levels after MBS, the signs of dehydration to look out for, and strategies to help you meet your daily fluid goals. Fluid Intake Recommendations After surgery, patients may have challenges consuming the recommended 64-72 ounces of fluid per day, especially in the immediate postoperative period. Patients may find they are sensitive to temperatures, have aversions to tastes or smells, or feel an uncomfortable fullness after drinking fluids. This uncomfortable feeling following fluid intake can be caused by drinking too quickly, trapped gas in the newly formed stomach pouch, or intolerance to a particular beverage, even water. While fluid intake can be challenging post-surgery, things do get easier. As your healing process progresses, tolerance generally improves, making getting your recommended daily ounces of fluid more manageable. Symptoms Of Dehydration Symptoms of dehydration are more than unpleasant and can require medical attention. Side effects of dehydration can include: Dizziness Confusion Electrolyte imbalance Little to no urine output Kidney damage Dry mouth and eyes Nausea If not treated, these symptoms can quickly become serious. Dehydration can lead to organ shutdown and the need for serious medical attention. For these reasons, maintaining proper hydration following any type of surgery is imperative. Everyone is at risk for dehydration. However, patients who have undergone bariatric surgery have slightly higher risk factors. After surgery, your body goes through significant metabolic changes and weight loss, which alone can increase your risk of dehydration. Other risk factors are related to the bariatric diet you will follow after surgery. This includes not drinking large volumes at once, avoidance of eating and drinking together, and a diet high in protein and vitamin-mineral supplements. If you feel you are not consuming enough water, be proactive and consult with a healthcare provider or dietitian. How to Increase Fluid Intake The first step to increasing your fluid intake is simply remembering to consume enough fluids. It may be helpful to set alarms or carry a water bottle around with you Choose fluids that are decaffeinated, sugar-free, carbonation-free, and alcohol-free. Water is ideal, but this can also include tea, black coffee, skim milk, and soy beverages. If you find you have lactose intolerance after surgery, digestive enzymes may be suggested as well as lactose-free beverages.* Following these recommendations can help you avoid natural diuretics, built-up gas, and unnecessary calories.* Even the temperature of fluids can play a role in fluid intake. Try changing the temperatures of your beverages and assess your tolerance. For example, you may find that you tolerate room temperature water better than ice water. It may sound boring to drink water, but remember there are many options to choose from. Try spring water, electrolyte-enhanced waters, infused water, or flavor enhancers like Crystal Light. Experiment with the different types of water to determine your preference. Another common post-op recommendation is to avoid using straws, at least initially. Drinking from a straw can cause too much gas to collect in the stomach pouch. Be sure to always drink slowly and do not gulp. Thirst vs. Hunger After surgery, your body may not send you the same hunger and thirst cues. Don’t wait until you are dehydrated to start drinking. This is a losing battle! How can you tell the difference between hunger and thirst? Sometimes thirst manifests itself as hunger. Try sipping on a full glass of water and wait 15-20 minutes before looking for a snack. Hunger has a gradual onset with stomach growling and light-headedness. If you find this feeling persists, you’re likely hungry. Nonetheless, be aware that thirst is commonly confused with hunger, especially in the postoperative period. Summary Dehydration is not something to take lightly. Prevention is key. Remember that eating, drinking, and tolerance issues will improve as you heal and progress. Be patient as your body’s metabolism adjusts to your new physiology. While water is ideal, plenty of fluid options exist to help you reach your daily hydration goals. Be aware of the signs of dehydration: dizziness, confusion, low urine, nausea, or dry mouth and eyes. Seek medical attention if you have fluid intake issues due to your smaller stomach. Stay patient, diligent, and positive. Always remember why you chose the bariatric path in the first place. The results will be well worth your efforts! References Rev Gastroenterol Mex (Engl Ed). 2021 [PMID: 34972678] This blog is for information and education purposes only. This information is not intended to substitute professional medical advice, diagnosis, or treatment. Please consult with your bariatric surgeon or another qualified healthcare provider with any questions in regards to a medical condition. A qualified healthcare professional can best assist you in deciding whether a dietary supplement is suitable based on your individual needs. *These statements have not been evaluated by the Food and Drug Administration (FDA). These products are not intended to diagnose, treat, cure, or prevent any disease.