Exsiccosis refers to dehydration of the human body due to a lack of fluid and the consequent reduction of body water. Often this is confused with a so-called dehydration, but which only describes an acute lack of water, which is a precursor of the exsiccosis.
Especially infants and old people are particularly often affected by exsiccosis. The former because they have only a very small supply of liquid, which they could fall back on in the case of a defective supply.
In older people, on the other hand, the thirst sensation, which often decreases with age, and a severely restricted intake of fluid in the event of an acute thirst, cause exsiccosis. Patients with dementia may experience dehydration if there is a neglect of their respective carers' needs.
But even young people and children who have already passed the age of infancy, may suffer from exsiccosis. In this context, illnesses such as diabetes, diarrhea or physical ailments such as disphagia (dysphagia), kidney problems or burns often play an important role.
If necessary, the use of diuretics, ie drugs that lead to dehydration of the body, contribute to the development of exsiccosis. In addition to all these causes, however, a long-lasting imbalance of fluid intake and fluid delivery can lead to exsiccosis.
Exsiccosis is characterized by a variety of different symptoms. An unmistakable sign of dehydration, however, is the stagnation of freshly pulled skin folds. The skin and mucous membranes feel dry. Furthermore, the patient stands out due to increased excitability with erratic, hasty and aimless movements that alternate with abnormal drowsiness.
The excreted amount of urine decreases sharply. In extreme cases, the body does not give off urine at all. Urinary substances are withheld. Due to the strong fluid loss, there is also a strong drop in blood pressure, which can lead to a circulatory shock.
The lack of fluid also causes the viscosity of the blood to increase. As a result, there is a higher risk of developing thrombosis. In addition, it leads to heavy weight loss, constipation, seizures and kidney pain. Especially elderly patients then suffer from extreme drowsiness, agitation, confusion, disorientation and general state of health.
In severe cases, it can also lead to unconsciousness. Without rapid treatment, the exsiccosis can lead to death. After successful treatment with infusions with an electrolyte solution, however, the condition of the patients normalises again very quickly. Even patients who were conspicuous by their high aggressiveness are suddenly completely normal again. However, many sufferers can no longer remember the previous condition.
The symptoms of exsiccosis vary greatly, ranging from a barely audible dehydration of the mucous membranes and slight concentration disturbances to severe headache, dizziness, muscle cramps, a feeling of weakness, palpitations or problems with chewing and swallowing.
However, the clearest sign of exsiccosis is when wrinkles on the back of the hand do not come off and persist for a long time. If no countermeasures are taken, in most cases exsiccosis leads to oliguria, ie too little excretion of urine and thus to a disturbed metabolism and electrolyte balance.
This can then cause an anuria, in which almost no urine is excreted, which can sometimes be life-threatening. In addition, due to the lack of flushing of the urinary tract, the risk of suffering from a disease such as an infection increases considerably. Exsiccosis is found to be either due to an increased sodium or hematocrit content in the blood, an elevated body temperature (the so-called "thirst fever") or a low central venous pressure (ZVD). Inhaled neck veins also indicate exsiccosis.
Exsiccosis can lead to very different and serious complications. If a person is dehydrated, his skin also loses its fluid. As a result, it is more susceptible to wounds and infections. Especially in old people there is a risk of decubitus.
A pressure ulcer is a pressure sore. This can result in late stages of complete death of the affected skin areas. In addition, exsiccosis inevitably leads to constipation. This is associated with other possible complications affecting the entire gastrointestinal tract. The lack of fluid causes dizziness which increases the risk of falls. It can also come to a so-called oliguria.
In an oliguria, the excretion of urine is limited. Out of this condition an anuria can arise. This means that less than 100 milliliters of urine are excreted during the day. The result is that no more urine-dependent substances can be excreted. Further complications such as disturbances of the electrolyte and water balance may result. As a result, kidney failure can have far-reaching negative effects.
In addition, pulmonary edema and cardiac arrhythmia may occur. In later stages of dehydration, the rheology of the blood is greatly altered. The rheology describes the composition of substances. As a result, heart attacks and strokes may occur. These lead to further complications such as speech disorders and paralysis. They can end in the worst case.
In the treatment of exsiccosis, the normalization of the fluid balance is usually the top priority. Since the patients to be treated but in many cases because of the side effects of dehydration, uncooperative, unconscious and sometimes very irritated or even become palpable, the supply of sufficient fluid is often very complicated dar.
Therefore, it has to be decided on a case-by-case basis which method of liquid addition is the most promising and most feasible.
Either oral or bucket feeding, an infusion or artificial feeding via a nasogastric tube or a percutaneous endoscopic gastrostomy that provides an artificial access to the stomach through the abdominal wall is possible. As soon as the fluid balance returns to a healthy level, the symptoms of exsiccosis usually disappear within hours or fewer days.
Dehydration always leads to death within a few days, unless action is taken. Within three days, various symptoms, such as hallucinations, the onset of delirium or coma and significant onset of weakness, follow. In addition, kidneys with persistent exsiccosis are affected.
The dehydration progresses the faster, the hotter the environment of the affected person is. Diarrheal diseases also accelerate the process.
First episodes of dehydration also show up within a day, because the skin contracts and the sufferers complain of a dry mouth (which is also noticeable in some cases odor). The fluid loss also causes a loss of nutrients and minerals.
This additionally damages the body in its function and structure. Transient fluid loss can be resolved within the three days. It may be necessary to administer fluid with nutrients intravenously. It is almost impossible that the affected person does not recover.
However, possible consequential damage - especially to the kidneys - can not be ruled out and depends on the general condition of the person affected and the duration of the exsiccosis.
The best prophylaxis against exsiccosis is the daily intake of plenty of fluid. Thus, experts recommend the intake of about 2 liters of liquid (excluding alcoholic beverages) daily.
In addition, the consumption of pectin-containing foods such as apples, oranges or carrots can promote the binding of water in the body, which is then excreted only very slowly through the intestine and can thus counteract exsiccosis.
Since elderly, people in need of care and infants frequently suffer from exsiccosis, their close observation by nursing staff or the parents is recommended since dehydration can have dire consequences. However, it can be easily avoided by drinking plenty and regular consumption of fruit.
There is no adequate aftercare after a dehydration of the body, inasmuch as the affected person is otherwise completely healthy (mentally as well as physically). Aftercare is synonymous with precaution, if anything. This essentially consists of not even letting it come to a dehydration risk, ie to absorb enough liquid.
A follow-up in the sense of a reduction of another risk for the occurrence of exsiccosis exists only in bedridden and mentally impaired persons. This can be explained by the fact that they represent the skin risk group. Dehydration can take place here in that the person concerned has taken too little liquid.
This may be the case if the feeling of thirst is missing or if the physical abilities are not sufficient to supply oneself with fluid. In such cases, nursing measures or even the artificial supply of fluid (by drip or probe) are indicated.
In physically healthy people with mental illness, which greatly affect the memory, also helps to monitor the drinking behavior. In both cases, it may also be useful to prophylactically rearrange the diet as part of a follow-up.
The targeted administration of fiber (especially pectins) helps to concentrate the water supplies in the body and cause a slow release of the existing liquid. This means that even large amounts of drinking water can be kept in the body for several hours at a time and so no continuous supervision or even force-feeding with liquid must be done.
If you suspect dehydration, you should first talk to the family doctor. Whether it is a dehydration, can be identified by typical symptoms such as headache, psoriasis, indigestion and back problems. An advanced dehydration is noticeable by the fact that folds of skin on the hand regress only after a few seconds.
In addition to the doctor's visit, the fluid balance must be compensated as soon as possible to prevent a life-threatening course. Depending on the severity of the dehydration, it may be necessary to administer the liquid in small doses or even to initiate an artificial diet or an infusion.
In case of a slight fluid deficiency it may be sufficient to take a lot of water as well as herbal tea or fruit tea. By eating salty broths, the accompanying nutrient deficiency can be compensated. The electrolyte balance can be regulated by fortified drinks and a wholesome diet.
In addition to these dietary measures, the cause of the dehydration must be determined. If the dehydration is based on a condition such as diarrhea or fever, bed rest and light medication are recommended. If an excessive intake of caffeine or alcohol is responsible for the dehydration, a change in diet may make sense.