Water intoxication - wikipedia Water intoxication Not to be confused with Hydrocephalus. Water intoxication Water molecule Classification and external resources Specialty toxicology, critical care medicine ICD - 10 E87. 7 ICD - 9 - CM 276.69 DiseasesDB 29222 MeSH D014869 ( edit on Wikidata ) Water intoxication, also known as water poisoning or hyperhydration, is a potentially fatal disturbance in brain functions that results when the normal balance of electrolytes in the body is pushed outside safe limits by overhydration ( excessive water intake ). Under normal circumstances, accidentally consuming too much water is exceptionally rare. Nearly all deaths related to water intoxication in normal individuals have resulted either from water - drinking contests, in which individuals attempt to consume large amounts of water, or from long bouts of exercise during which excessive amounts of fluid were consumed. In addition, water cure, a method of torture in which the victim is forced to consume excessive amounts of water, can cause water intoxication. Water, just like any other substance, can be considered a poison when over-consumed in a specific period of time. Water intoxication mostly occurs when water is being consumed in a high quantity without adequate electrolyte intake. Excess of body water may also be a result of a medical condition or improper treatment ; see `` hyponatremia '' for some examples. Water is considered as one of the least toxic chemical compounds, with an LD of over 90 ml / kg in rats. Contents 1 Risk factors 1.1 Low body mass ( infants ) 1.2 Endurance sports 1.3 Overexertion and heat stress 1.4 Psychiatric conditions 1.5 Iatrogenic 2 Pathophysiology 3 Prevention 4 Treatment 5 Notable cases 6 See also 7 References 8 External links Risk factors Low body mass ( Infants ) It can be very easy for children under one year old to absorb too much water, especially if the child is under nine months old. Because of their small body mass, it is easy for them to take in a large amount of water relative to body mass and total body sodium stores. Endurance sports Marathon runners are susceptible to water intoxication if they drink too much while running. This is caused when sodium levels drop below 135 μmol / L when athletes consume large amounts of fluid. This has been noted to be the result of the encouragement of excessive fluid replacement by various guidelines. This has largely been identified in marathon runners as a dilutional hyponatremia. A study conducted on participants of the 2002 Boston marathon found that thirteen percent finished the race with hyponatremia. The study concluded that the strongest predictor of hyponatremia was weight gain while racing ( over-hydration ), and hyponatremia was just as likely to occur in runners who chose sports drinks as those who chose water. Medical personnel at marathon events are trained to suspect water intoxication immediately when runners collapse or show signs of confusion. Overexertion and heat stress Any activity or situation that promotes heavy sweating can lead to water intoxication when water is consumed to replace lost fluids. Persons working in extreme heat and / or humidity for long periods must take care to drink and eat in ways that help to maintain electrolyte balance. People using drugs such as MDMA ( often referred to colloquially as `` Ecstasy '' ) may overexert themselves, perspire heavily, feel increased thirst, and then drink large amounts of water to rehydrate, leading to electrolyte imbalance and water intoxication -- this is compounded by MDMA use increasing the levels of antidiuretic hormone ( ADH ), decreasing the amount of water lost through urination. Even people who are resting quietly in extreme heat or humidity may run the risk of water intoxication if they drink large amounts of water over short periods for rehydration. Psychiatric conditions Psychogenic polydipsia is the psychiatric condition in which patients feel compelled to drink large quantities of water, thus putting them at risk of water intoxication. This condition can be especially dangerous if the patient also exhibits other psychiatric indications ( as is often the case ), as the care - takers might misinterpret the hyponatremic symptoms. Iatrogenic When an unconscious person is being fed intravenously ( for example, total parenteral nutrition ) or via a nasogastric tube, the fluids given must be carefully balanced in composition to match fluids and electrolytes lost. These fluids are typically hypertonic, and so water is often co-administered. If the electrolytes are not monitored ( even in an ambulatory patient ), either hypernatremia or hyponatremia may result. Some neurological / psychiatric medications ( Oxcarbazepine, among others ) have been found to cause hyponatremia in some patients. Patients with diabetes insipidus are particularly vulnerable due to rapid fluid processing. Pathophysiology At the onset of this condition, fluid outside the cells has an excessively low amount of solutes, such as sodium ( hyponatremia ) and other electrolytes, in comparison to fluid inside the cells, causing the fluid to move into the cells to balance its concentration. This causes the cells to swell. In the brain, this swelling increases intracranial pressure ( ICP ), which leads to the first observable symptoms of water intoxication : headache, personality changes, changes in behavior, confusion, irritability, and drowsiness. These are sometimes followed by difficulty breathing during exertion, muscle weakness & pain, twitching, or cramping, nausea, vomiting, thirst, and a dulled ability to perceive and interpret sensory information. As the condition persists, papillary and vital signs may result including bradycardia and widened pulse pressure. The cells in the brain may swell to the point where blood flow is interrupted resulting in cerebral edema. Swollen brain cells may also apply pressure to the brain stem causing central nervous system dysfunction. Both cerebral edema and interference with the central nervous system are dangerous and could result in seizures, brain damage, coma or death. Prevention Water intoxication can be prevented if a person 's intake of water does not grossly exceed their losses. Healthy kidneys are able to excrete approximately 800 millilitres to 1 litre of fluid water ( 0.84 - 1.04 quarts ) per hour. However, stress ( from prolonged physical exertion ), as well as disease states, can greatly reduce this amount. Treatment Mild intoxication may remain asymptomatic and require only fluid restriction. In more severe cases, treatment consists of : Diuretics to increase urination, which are most effective for excess blood volume. Vasopressin receptor antagonists Notable cases 1991, Andy Warhol : Five years after his death, Warhol 's family publicly accused the hospital where he had his gallbladder removed of causing his death by water intoxication administered post-operatively. A claimed autopsy weight of 150 lbs, with his weight being 128 lbs when admitted, was cited as evidence that too much fluid has been given. October 24, 1995 : Anna Wood, a 15 - year - old Australian schoolgirl died from the effects of water intoxication secondary to use of MDMA ( commonly known as Ecstasy ). November 16, 1995 : Leah Betts, an English schoolgirl, died as the result of drinking too much water, though in the media her death was mistakenly attributed to taking an ecstasy tablet at her 18th birthday party. 2003 : British actor Anthony Andrews survived a case of water intoxication. He was performing as Henry Higgins in a revival of the musical My Fair Lady at the time, and consumed up to eight litres of water a day. He was unconscious and in intensive care for three days. January 12, 2007 : Jennifer Strange died after drinking what is believed to be 7.5 litres of water, in an attempt to win a Nintendo Wii. The KDND radio station morning show, the Morning Rave, held an on - air contest entitled Hold Your Wee for a Wii, in which contestants were asked to drink as much water as they could without urinating. KDND was subsequently ordered to pay £ 10m in damages to Jennifer 's family. See also Water portal Electrolytes Dehydration Drowning Hyperkalemia / Hypokalemia Hypermagnesemia / Hypomagnesemia Hypernatremia / Hyponatremia Gastroenteritis Oral rehydration therapy Polydipsia Water urticaria Dihydrogen monoxide hoax Electrolyte imbalance List of unusual deaths Potomania The dose makes the poison References Jump up ^ Noakes TD, Speedy DB ( July 2006 ). `` Case proven : exercise associated hyponatraemia is due to overdrinking. So why did it take 20 years before the original evidence was accepted ? ''. British Journal of Sports Medicine. 40 ( 7 ) : 567 -- 72. doi : 10.1136 / bjsm. 2005.020354. PMC 2564296. PMID 16799109. Jump up ^ Farrell DJ, Bower L ( Oct 2003 ). `` Fatal water intoxication ''. Journal of Clinical Pathology. 56 ( 10 ) : 803 -- 804. doi : 10.1136 / jcp. 56.10. 803 - a. PMC 1770067. Jump up ^ ( 1 ) -- see to Section 11 : Toxicological Information for the LD verification Jump up ^ `` Water Intoxication in Infants ''. Retrieved 31 August 2015. ^ Jump up to : Almond CS, Shin AY, Fortescue EB, et al. ( April 2005 ). `` Hyponatremia among runners in the Boston Marathon ''. The New England Journal of Medicine. 352 ( 15 ) : 1550 -- 6. doi : 10.1056 / NEJMoa043901. PMID 15829535. Jump up ^ Timbrell, John ( 2005 ). The Poison Paradox : Chemicals as Friends and Foes. OUP Oxford. ISBN 978 - 0 - 19 - 280495 - 2. Jump up ^ Zerbe, Robert L. ; Robertson, Gary L. ( 1981 - 12 - 24 ). `` A Comparison of Plasma Vasopressin Measurements with a Standard Indirect Test in the Differential Diagnosis of Polyuria ''. New England Journal of Medicine. 305 ( 26 ) : 1539 -- 1546. doi : 10.1056 / NEJM198112243052601. ISSN 0028 - 4793. PMID 7311993. Jump up ^ Schwaderer AL, Schwartz GJ ( April 2005 ). `` Treating hypernatremic dehydration ''. Pediatrics in Review. 26 ( 4 ) : 148 -- 50. doi : 10.1542 / pir. 26 - 4 - 148. PMID 15805238. Jump up ^ `` Oxcarbazepine ''. Retrieved 31 August 2015. Jump up ^ What Is Diabetes Insipidus ? Jump up ^ Moreau, David ( 2008 ). Fluids & Electrolytes Made Incredibly Easy ! ( 4th ed. ). Philadelphia : Lippincott Williams & Wilkins. pp. 75 -- 77. ISBN 978 - 1582555652. ^ Jump up to : Coco Ballantyne. `` Strange but True : Drinking Too Much Water Can Kill ''. Retrieved 31 August 2015. Jump up ^ `` Care Faulted In the Death Of Warhol ''. NYT. Retrieved 27 October 2013. Jump up ^ `` Hyponatremia ( '' Water Intoxication `` ) ''. The DEA.org. Retrieved May 10, 2007. Jump up ^ Grice, Elizabeth ( August 21, 2003 ). `` My battle with the bottle ''. The Daily Telegraph. London. Jump up ^ Valentine Low ; Evening Standard ( 3 July 2003 ). `` Actor tells of water overdose ''. Evening Standard. Retrieved 31 August 2015. Jump up ^ http://www.dailymail.co.uk/news/article-1224051/Wee-For-Wii-water-drinking-contest-death-Jennifer-Stranges-family-awarded-10m.html External links BBC news feature on water intoxication Electrolyte imbalance and acid -- base imbalance ( E86 -- E87, 276 ) Volume status Volume contraction ( dehydration / hypovolemia ) Hypervolemia Electrolyte Sodium High Hypernatremia Salt poisoning Low Hypotonic Isotonic Potassium High Low Chloride High Low Calcium High Low Acid -- base Acidosis Metabolic : High anion gap Ketoacidosis Diabetic ketoacidosis Lactic Normal anion gap Hyperchloremic Renal tubular Respiratory Alkalosis Metabolic Contraction alkalosis Respiratory Both Mixed disorder of acid - base balance NDL : 01202638 Retrieved from `` https://en.wikipedia.org/w/index.php?title=Water_intoxication&oldid=813733322 '' Categories : Electrolyte disturbances Intoxication Body water Substance intoxication Hidden categories : Infobox medical condition Talk Contents About Wikipedia Català Dansk Deutsch Español Esperanto فارسی Français 한국어 Italiano עברית Nederlands 日本 語 Polski Русский Slovenščina Suomi Svenska ไทย Tiếng Việt 中文 Edit links This page was last edited on 4 December 2017, at 23 : 32. 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Question: why do you die if you drink too much water
Answer: the normal balance of electrolytes in the body is pushed outside safe limits by overhydration (excessive water intake)