Fluids are essential for many bodily functions, including digestion. They play a role in both constipation and diarrhea. So when you're dealing with IBS symptoms, it's important to look not only at what you're drinking, but also how much.
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Fluids and Digestion
More than half of your body is made up of water. It is the essence of life. It provides the solution in which all essential biochemical processes occur that produce and sustain life. It controls your body temperature, cushions your organs, and lubricates your joints.
Water is also involved in every step of the digestive process, including:
Saliva to moisten food for chewing and to provide digestive enzymes
Watery gastric juices in the stomach to break down food and mucus to protect the lining of the stomach from acids
Transporting enzymes and other things into the small intestine to break down food and then transporting nutrients back into your bloodstream
Bulking up and softening stool in your large intestine, making BMs more regular and easier to pass.
Water also plays a role in constipation and diarrhea, which means it's important for everyone with IBS.
Fluids and Constipation
In normal digestion, as the liquid remains of food move through the large intestine it absorbs water to form poop. Muscle contractions push the poop toward the rectum and by the time it gets there most of the water has been absorbed, making it solid.
But if you don't have enough water in your body already, the large intestine will take more from your poop. This can make your poop harder and drier and more difficult to pass.
Proper hydration can make your poop softer and easier to pass. Water is also necessary to properly digest soluble fibre and is especially important if you are trying to increase your fibre intake.
Of course there's always a catch. When contractions in the muscles of the large intestine are sluggish (as can happen with IBS), your poop can move through too slowly and too much water can be absorbed. But if you are properly hydrated, at least you're one step ahead of the game.
Studies have shown that drinking above the recommended intake for fluids doesn't really help with constipation, so you don't need to overdo it.
Fluids and Diarrhea
If you have diarrhea it's important to stay hydrated, because your body is losing fluid. During a bad bout of diarrhea, you may become dehydrated. Be sure to drink extra fluids.
You also lose electrolytes when you have diarrhea. Electrolytes are minerals like sodium, potassium and chloride that aid in many cellular functions. Dehydration can cause an imbalance.
If diarrhea is mild, you can probably get enough electrolytes from food and beverages. Put a couple extra shakes of salt on your food and eat potassium rich foods like bananas, cantaloupe, avocados, sweet potatoes or spinach.
If diarrhea is mild to moderate, you might consider an oral rehydration solution (ORS), like Pedialyte recommended by the WHO. Many people use sports drinks to replace electrolytes, but these are designed for losses through sweat and not diarrhea. They may be helpful if diarrhea is mild. If diarrhea is severe or chronic, it's best to talk to your doctor.
Tips for Proper Hydration
So what is the "right" amount of hydration and how do you achieve it?
In this section find out more about what counts as a fluid, how much you should be drinking, the signs and symptoms of mild dehydration, factors that affect hydration status and some hydration hacks to help with your fluid intake.
What Counts as a Fluid?
Fluids include water and other beverages, like juice, milk, broths, coffee and tea. The foods you eat, especially those high in water content like melons or tomatoes, can contribute around 20% of your overall intake.
Drink More Often...
Water is the best drink choice, because it has no calories, sodium, sugar or unsaturated fat.
Carbonated water could liven things up, but if your IBS symptoms include gas and bloating you may want to give them a pass. Ditto for using a straw. ( See Common IBS Food and Drink Triggers)
Other drinks like milk, unsweetened teas and enriched, unsweetened plant based drinks are nutritious alternatives to mix things up.
Drink Less Often...
Sugary drinks like sweetened coffees and teas, sodas and fruit juices should be a treat and not a regular go to for quenching your thirst. Same for drinks like vegetable juices, which can be high in sodium, and fancy coffee drinks, which can be high in saturated fat.
Some beverages can be diuretics, which means they make you pee more and you may end up losing fluids. The most common are alcohol and those that contain caffeine.
Alcohol can affect a fluid-regulating hormone in your body that signals your kidneys to reduce peeing and reabsorb water back into your body. If this hormone isn't activated, your body flushes out water more easily. So more than a couple of drinks in a short time can increase your risk of dehydration, especially if you haven't eaten. It also depends what you're drinking. Shots will dry you out faster than a tall gin and tonic. Still it's best to eat while you're drinking and make sure you drink water along with your cocktail.
Alcohol can also worsen IBS symptoms. (See Common IBS Food and Drink Triggers)
Caffeine is often thought to have a diuretic effect, but research doesn't fully support this. It suggests that more than 2 cups of coffee may have this effect in some people, but won't necessarily lead to dehydration.
So a couple of cups of a caffeinated beverage, like coffee or tea, can be included in daily fluid intake. Keep in mind that caffeine may also affect IBS symptoms (See Common IBS Food and Drink Triggers)
How Much Should You Drink?
Every body is different, so as it is with so many things, it depends.
Even trusted sources for nutrition information don't agree on the exact numbers when it comes to fluid intake, but they do agree that the numbers are a just a general guideline and can be influenced by many factors. Fluid intake is highly individual and can vary from day to day.
Dietitians of Canada recommends that you drink:
2.2 L (9 cups or 72 ounces) of fluids for women 19+
3 L ( 12 cups or 96 ounces) of fluids for men 19+
To figure out if you are properly hydrated, keep the following in mind:
If you're thirsty, then drink.
When you feel thirst, you're already a bit dehydrated. Best to drink fluids throughout the day.
The factors listed below may affect your hydration status, so adjust your fluid intake accordingly.
If you think you may not be drinking enough, check for signs of dehydration.
Factors That Affect Hydration
Your body composition changes as you age and you have less water in your body. This means your water reserves are lower and you will be more easily dehydrated. Kidney function may not be as good, which also means less water available to your body.
Your sense of thirst also lessens as you age, which means that already lower reserves aren't being topped up. Medications can also affect hydration status, as can chronic illnesses such as diabites or dementia.
Guidelines say that men need to drink more water than women. Fat tissue has a lower percentage of water than lean tissue and women tend to have more fat, so the percentage of body weight that is water in the average woman is lower. On average, men also have larger bodies to supply. But these are merely averages and you will have to adjust for your particular body size and composition.
You need to replace the water you lose from sweating when you exercise. It's best to drink water before, during and after.
Your body will also lose water sweating in hot and humid weather, so make sure you up your fluid intake to make up for those losses.
Insoluble fibre draws water into your intestines and water is needed to properly digest insoluble fibre. Often one of the first things you may try to help with digestion is to increase your fibre intake. Make sure you are also drinking more fluids.
Signs of Mild Dehydration
Your body loses water mainly by sweating, breathing and getting rid of waste. Basically if you lose more fluid than you take in, you can get dehydrated. Remember that you can become mildly dehydrated before any signs appear, so it's important to drink fluids throughout the day.
The best way to figure out if you're drinking enough is by paying attention to your pee...
If it's light yellow and clear, you're probably drinking enough.
If it's dark yellow and strong smelling, you're probably dehydrated and you should drink up!
Some foods, meds and vitamin supplements can affect the colour of your pee, so if you're concerned check with your doctor.
It is possible to drink too much, although that's pretty rare. So you don't need to overdo it.
Other signs of mild dehydration include:
thirst and dry lips and mouth
tiredness, irritability, headache, dizziness or fainting
low blood pressure or increased heart rate
Here are some tips and tricks for staying properly hydrated.
Set a goal, try a few and pick the ones that are right for you!
Make Hydration a Habit
The best way to remember to do something is to make it part of your routine.
Drink a glass of water with every meal. Sipping on fluids while you eat can aid digestion.
Ask for a glass of water with your meal when you eat out.
Drink water before, during and after exercise.
Drink a glass of water when you wake up, brush your teeth, use the bathroom or before bed.
Drink a full glass of water with meds or supplements.
Stick to the one for one rule when drinking alcohol - e.g. one glass of water for each beer.
Track your intake and set reminders using a fancy water bottle or an app.
Challenge yourself or a friend and reward yourself if you meet your goal.
Make Fluids Easily Available (Especially Water!)
Out of sight and out of mind is a real thing, so keep fluids handy and, if possible, within view.
Carry water in a reusable water bottle when you go out or exercise.
Have the bottle on your desk while you're working or close by when you're watching TV.
When you finish the bottle, immediately fill it up again.
Keep a pitcher of water in the fridge (and keep fewer sugary drinks in the house).
Put a pitcher of water on the table during meals.
Mix It Up!
Is plain water just too boring? Then mix it up with some other healthy options.
Add flavour using fruits, vegetables, herbs or a few dashes of almond or coconut extract.
Making your own flavoured water is best, as store bought liquids and powders often have added sugar or salt. Be sure to check the labels.
Sparkling or mineral water could add some pizzazz, but if you suffer from gas and bloating you may want to stay away from carbonated beverages.
Eat your water. Many fruits and veg have a high water content, like melons, cucumbers, lettuce and celery.
Try herbal teas, both hot and cold, milk or plant based drinks. Unsweetened is best.
Freeze fresh fruit and use as ice cubes or make your own fruit popsicles.
If you're having trouble giving up soda or juice, try alternating with glasses of water or watering them down with lots of ice cubes.