Everyone's needs will be different. We live in different climates, have different activity levels, sweat and absorb different amounts, and have different kidney function. The real goal is an amount that keeps you peeing light-colored urine several times a day. 

thanks, I don't do that several times a day....So I'm dehydrated!

I dehydrated many times when I had my loop ileostomy; to such an extend, on each occassion I was rushed to hospital by ambulance for IV rehydration.

I was advised that, as a guide, I should consume enough fluids so I urinate at least 3 to 4 times per day, urines hould be of a light straw colour regardless.

If feeling fatigued and suffering from cramp, then your electrolytes require replenishing.

When I feel fatigued, I drink the St Marks emix solution.

When I first had my pouch and was released from the hospital I was told to drink.  I also had the loop ileo at the time.  Well.  Needless to say by me not listening two days out I passed out black and blued the side of my face and it put me in the hospital for another 17 days!  

Even now that that is all over with I live in a hot state and minimum I drink 6 bottles a day.  Today was 100 degrees.  I can down a whole bottle at once and still need more.  So I lost count today.  I work outside.  Not in direct sunlight but outside nonetheless.  I can tell by the way I feel if I am getting dehydrated.  After three years with no colon my body has certain signs I recognize. 

But like Scott said.  All depends on the individual.

Richard. 

Mysticobra posted:

When I first had my pouch and was released from the hospital I was told to drink.  I also had the loop ileo at the time.  Well.  Needless to say by me not listening two days out I passed out black and blued the side of my face and it put me in the hospital for another 17 days!  

Even now that that is all over with I live in a hot state and minimum I drink 6 bottles a day.  Today was 100 degrees.  I can down a whole bottle at once and still need more.  So I lost count today.  I work outside.  Not in direct sunlight but outside nonetheless.  I can tell by the way I feel if I am getting dehydrated.  After three years with no colon my body has certain signs I recognize. 

But like Scott said.  All depends on the individual.

Richard. 

what are your signs?

Lightheaded.  Ringing in my ears.  And just a feeling I know I have not had enough water.  It's hard to explain that part.  It's an overall feeling.  Standing up fast and getting lightheaded is a sure sign.  Or really just standing up at my age.  I don't get it much.  I drink constantly. 

Funny thing is before I went through all of this I hardly drank anything at work.  I would have a coke at lunch and a few sips.  I don't know how I got away with that.  I have a water bottle with me at all times no matter where I go. 

Richard. 

About the only "disability" all J-pouchers share is impaired water absorption. I treat water as essential medicine. Perhaps as a result I've been fortunate enough to never become dehydrated over my 16 years with a pouch. 

Unless your thirst mechanism is not functioning properly you should rely on that. I'm sure they're people on hear that will disagree but drink when you're thirsty. That's all I've ever done and have never become dehydrated due to not drinking enough. If on the other hand you have a bad case of pouchitis or something then that method will not work as well and you have to force the fluids.

dew posted:

Unless your thirst mechanism is not functioning properly you should rely on that. I'm sure they're people on hear that will disagree but drink when you're thirsty. That's all I've ever done and have never become dehydrated due to not drinking enough. If on the other hand you have a bad case of pouchitis or something then that method will not work as well and you have to force the fluids.

BINGO! 

Why couldn't I think of that.  I worked 10 hours yesterday. 

Sure wasn't brain freeze in this heat.  

But your right.  I said it above and couldn't come up with what you said. 

Sometimes I can down a whole bottle at once refill it and drink more.  

If your thirsty.  Drink.    Jeez.. 

Richard. 

I never feel thirsty, can't remember a time when I've ever felt " thirsty."

On occasions I do tend to always feel hungry and apparently always feeling hungy, especially soon after eating, is a sign of dehydration and our bodies, especially mine, misunderstanding the signals.

The colon normally absorbs fluid so once removed, we need to consume more fluids to compensate and also replenished our electrolytes.

For myself and some forum member, drinking when feeling thirsty, it's not as clear cut as that; I found dehydration crept up on me, I begin to feel tired and before I knew it, I found myself unable to stay awake and I lacked the motivation to actually get up an make a drink.

Once I've dehydrated to such an extend I need more than just fluids, I need to replenish my electrolytes too.

And that thirst mechanism diminishes as we age so that is something to keep in mind. I always have a big glass of water at my bedside too. 

A lot of good info. here....I think i've been chronically dehydrated with my pouch because I don't "feel thirsty" at times, but will get light headed when standing up at times and I don't feel like getting out of bed in the morning when I'm really dehydrated. I will begin to force more water consumption even though I don't "feel" thirsty.

I have had the same problem as you when I wake since I had my colon removed.  And being really exhausted easily as the day rolled by. 

I finally had my blood tested for everything about a month ago.  I mean every morning I was waking and feeling like I had been run over by a truck. 

Well come to find out my iron levels were low.  I have always  had high iron levels.  So it was a surprise to me.  Having it removed has something to do with iron absorption.  Read up on it and you may want to be tested. 

It has made a big difference in my energy levels and how I feel when I wake.  I don't feel so bad.  I am not dead tired after an eight hour shift.  I didn't realize how important iron is until I read up on it after I found out I had to take an iron supplement.  But even after three weeks of taking an iron supplement I can feel a noticeable difference.  

I am just happy it was something  simple.  I wouldn't want to live the rest of my life being chronically fatigued. 

Richard. 

I drink a lot of fluids (not just water but mostly) but not all fluids are of the same hydration value...I was pleased to hear that everyone was speaking about water consumption and not just fluids. Water is still the best hydrator for humans.

My thirst mechanism is off, or doesn't ring or I was trained out of it with all of the I.V.s and fasting so I do not get thirsty or confuse it with hunger too, like Strange. 

My doctor gave me 2 rules, 1 is when you are thirsty it is already too late.

You should not wait until thirst to drink but drink regularly and often...thirst means that it has already gone too far on the dehydration scale.

Next is drink when you are hungry and wait and see what happens...your hunger may just vanish.

I also keep a glass or bottle of water beside me at all times just in case.

Temoty, some of the other signs of dehydration can be mental confusion, inability to concentrate, irritableness, sweating, clamminess, anger, seeing things, dried out skin on the top of your hand and a loss of elasticity in your skin (it sort of hangs there)...it is often confused with dementia or Alzheimer's in older people when in fact they are really just dehydrated...plump them up and the problem goes away rather quickly. 

Sharon

I drink a cup of water with every meal and about 2 cups in between meals.  I also drink water while exercising and after exercising.

During my many hospital admissions for dehydration, I'm certain the Doctors advised that to ensure I remain hydrated, I should ensure I urinate NO LESS than 3 times a day, aiming for at least 3 or 4 times per day as a minimum.

Apparently, it's a more of a reliable guide to measure a safe fluid output rather than intake, as there's too many variables, such as size, age, activity etc.

Also, one persons fluid intake can be very different to someone else; where as the urine output, is the fluid the body no longers requires, regardless of how much fluid has been consumed. 

I've always drunk a lot of water every day, even before I had the pouch, around 2 to 3litres although I do a lot of exercise.

after takedown I was advised, at first to bring that down to a litre a day, as too much water can make you dehydrated as everything passes through too quick.

I was also told to make a rehydration drink and have a litre of that a day.

it helped a lot, after a month or so I didn't need it and I now drink the same amount of water I used to before I had the pouch. I never really get dehydrated.

fyi instructions for the home made drink are here:

http://www.surreyandsussex.nhs...-Electrolyte-Mix.pdf

My doctor told me i should aim for 80oz of water a day. i dont know where they got the number from but that amt keeps me peeing clear. i brought home 2 of the hopsital mugs that have measurements in oz on the side and ended up buying a larger 50oz bottle. i would have to say i def meet or exceed that 80oz daily

We are all different, and you may actually find that you need to drink less as time goes on, as your body does adapt.   It's natural in the beginning to feel that you need to drink constantly, but this can be dangerous in itself as if you drink too much, you are actually flushing out electrolytes. 

Do not let thirst guide you. If you are thirsty, you are probably already starting to become dehydrated. Also, I was told by a dietitian not to let urine colour guide me either, as it can be misleading. Darker urine does not necessarily mean you are dehydrated - supplements, diet, medication, etc all affect urine colour, so if you are drinking to obtain the so called "clear" or pale yellow urine,  you also have to factor in those issues when you are trying to gauge fluid intake. (for example, B vitamin supplements can turn your urine very yellow. Iron, beets, fava beans, and asparagus can also cause a darkening of the urine).

If you are looking for a guideline to start, the dietitian I saw after my colectomy suggested that I aim for 8 glasses of water a day initially (this is in addition to other fluids I would normally get in my diet - tea, soup, etc), and then adjust up and down from there depending on urine output (if you are peeing once at hour, for instance, you are probably drinking too much). Also, you are going to need more water if the weather is warmer or if you are exercising.  Remember too that tea, juice, soup, etc, all count toward fluids.

As Spooky points out, other things than dehydration can darken the urine. Frequency of urination can also be misleading, though, since different things can cause us to pee. If you're not taking those things that darken urine, or a reasonable amount of water is able to get your urine light-colored, then several light-colored episodes per day is a pretty good guide. You have to drink an awful lot of fluid to cause electrolyte problems if your kidneys are working properly. 

Myth: If you’re thirsty, you’re already dehydrated.
Fact: It’s not too late. In fact, thirst is the body’s way of telling you to drink water, and you’re not at risk of becoming dangerously dehydrated the minute you feel a little parched. “When you get thirsty, the deficit of water in your body is trivial — it’s a very sensitive gauge,” Dr. Stanley Goldfarb, professor of medicine at the University of Pennsylvania, told HuffPost in January. “It might be only a 1 percent reduction in your overall water. And it just requires drinking some  fluid.”

Dew, for most coloned people, and for many J-pouchers, thirst works just fine as an indicator. It isn't correct, however, to universally apply hydration advice for coloned people to J-pouchers. Folks without colons will dehydrate more quickly and rehydrate more slowly. A lot of folks here have become severely dehydrated under moderate conditions, and that's not a very common occurrence for people with complete intestines, and it's not because we pay less attention to thirst. This isn't a sales pitch for sports drinks, it's an acknowledgment of a consequence of an anatomical change.

Yeah, I dehydrated every month until takedown, to an extent that each occasion I was rushed to Hospital by Ambulance for IV fluids, think IV fluids was even administered in Ambulance too.

The dehydration totally crept up on me and even after the second time, I knew exactly what to expect.

I dehydrated to the point that I wasnt able to consume enough fluids orally to rehydrate.

I'm all too aware of the importance and need of a sufficient fluid intake, especialy during exertion and activities, as before my UC diagnosis, I'd always participated in some kind of fitness activity, also an avid cyclist during my early teens and weight lifting from 16 till my mid 20's, yet dehydration still caught me out.

I can never recall ever feeling thirsty, I tend to consume fluids because I'm hot or feeling exhausted, sensations that I don't associate with thirst.

At all other times. I believe I confuse thirst with hunger, which I've only come to such a conclusion since my bouts of dehydration (also read about it)  and, after a lifetime of such confusion, it's a difficult habit to break.

The loss of electrolytes is the danger; much worse than a dry mouth or feeling thirsty.  I guess the onset can be described as being similar to that of a hangover, although far more extreme, such as feeling groggy, irritable, fighting tiredness and longing for bed.

I've never experienced a hangover but I believe the symptoms of a hangover occur because the night before more fluids than normal have been consumed, which results in the need to urinate more often, which flushes away the much needed electrolytes.

Scott F posted:

As Spooky points out, other things than dehydration can darken the urine. Frequency of urination can also be misleading, though, since different things can cause us to pee. If you're not taking those things that darken urine, or a reasonable amount of water is able to get your urine light-colored, then several light-colored episodes per day is a pretty good guide. You have to drink an awful lot of fluid to cause electrolyte problems if your kidneys are working properly. 

Yes, exactly this. I should have qualified my post - I was sharing the info that the dietitian provided to me when I first had my colectomy, and also dispelling the myth some of us have that we need to "drink constantly" to stave off dehydration - that is not true.  The dietitian I saw shared a couple of incidents of patients with ileostomies who had developed problems from too much fluid intake.  The key is trying to find the balance, so aiming for 8 glasses of water to start and then adjusting up or down as needed, based on weather/climate, exercise, thirst, and urine colour was her advice to me. - though the urine colour factor came with the caveat to take into consideration other things you are ingesting that could cause a colour change.  Though certainly, if you aren't taking meds or supplements that might darken your urine, and you are experiencing dark urine, then that is a sign you probably need to drink more.

Great info here....I'm especially going to try drinking water when I'm hungry at times. I'm hungry A LOT.

I'm very often dehydrated as well, and I almost never feel thirsty. I also can't often tell what colour my urine is, since I rarely JUST pee. Yknow. Once, my doc told me I should just try to have a drink of water every time I go to the bathroom. Not always practical, but a good rule of thumb I follow whenever I can.

One thing I was thinking of trying is a private hydration clinic. There's one in my city, and I think it's becoming somewhat trendy, mostly for people who want "vitamin" infusions and quick hangover cures. But after a recent dehydration crisis that landed me in Emerg, I've thought about contacting them, and finding out what their facilities are, if they have RNs on staff to insert IVs or whatever. I figure, if it's affordable, it might save me some aggravation (not to mention exposure to all the nasties in hospital ERs!)

Onward!

KS

Between $30-$130.

I have also found that overall electrolyte balance is a much bigger problem than lack of water only. After 16 years with a pouch, I have it down to a science to manage though. I start feeling exactly like Strange said--almost like a hangover--where I feel nauseous, light headed, tired, and sometimes even a mild headache, just overall blah, all the while my pee is clear. This all happens when it's either really hot out, after a hard workout, or if I've been bad and consuming too much coffee or other dehydrating things. It's probably not the healthiest solution, but when I feel like this I eat a small bowl of salty chips and a 500ml Gatorade and voila! I feel better within an hour. Almost like a wilted plant who gets watered. So just plain water doesn't really help this and as others have said, too much water actually causes the same problem because all the salt and potassium gets flushed out. So how much water depends on diet/lifestyle/climate etc, so I have figured out how much I need based on how I feel overall, not by thirst or pee colour.  It probably averages out to 7-8 lasses/day (more on hot days and workout days). 

2 gallons or more

I drink when I'm thirsty. IMO there is no reason to drink more than that.

@dew posted:

I drink when I'm thirsty. IMO there is no reason to drink more than that.

Many doctors say its good to drink water before you get thirsty, when you are thirsty you are already dehydrated, its good to drink water before you get dehydrated. Many doctors state that and its stated in lots of articles as well.

I really think the key is the appearance of your urine. Many times you are not thirsty but the urine has a highly concentrated appearance, and isn't running clear.  That's when you need to hydrate, and if you aren't urinating you need to hydrate.

@Former Member posted:

Many doctors say its good to drink water before you get thirsty, when you are thirsty you are already dehydrated, its good to drink water before you get dehydrated. Many doctors state that and its stated in lots of articles as well.

Sorry but that is false, or maybe I should say an old wives' tale, possibly?

I'll look for the study later.

@Erik R posted:

I drink a cup of water with every meal and about 2 cups in between meals.  I also drink water while exercising and after exercising.

AWESOME!!!!!!

Update: My iron levels were low too. I now get Iron infusion about every 2 months.

@temoty posted:

Update: My iron levels were low too. I now get Iron infusion about every 2 months.

Does this make you feel better?  More energetic?

i apparently have stage 2 CKD as I am sure alot of people do as I have found out when they test your kidney function or eGFR the lab doesnt flag it if over 60. But between 60-89 i think they consider this stage 2 kidney disease.. i fluctuate between 60-75.  My nephrologist told me 2-3 liters a day.

Wow, that's a lot! 

@Sara Marie posted:

Does this make you feel better?  More energetic?

yes, it does....