*This article is intended for information only and is not intended to be medical advice. Get personal advice from your doctor or specialist.
It’s fair to say that the hydration drink market has exploded over the last few years. The market is literally awash with products and it’s super confusing.
Electrolyte fluids are often recommended when you have an ileostomy and can make a real difference to your energy levels and general health and may even prevent hospitalisation, especially just after surgery, during illness or during a heatwave.
The main reason to add electrolytes is to help to ‘superpower’ your water to improve absorption. Electrolytes in these drinks are are typically sodium, potassium and magnesium.
You need the right balance of sodium and glucose in the drink and this aids absorption. This ‘superpower’ absorption system is known as the sodium-glucose co-transport system – more on that later.
How do you know which drink to choose? This article is here to help.
Ileostomy needs
When you have an ileostomy, you will need to pay more attention to your hydration needs, especially in heatwaves, when travelling or when exercising.
For the average ileostomy, fluid loss is around 800-1500ml in output. So even a ‘well behaved’ stoma will create significant fluid loss over someone who doesn’t have a stoma.
The large bowel – colon – is where fluid and electrolytes are absorbed. So without it, it makes absorption of fluid and sodium more difficult. So even if you don’t have an especially high output stoma, your ability to absorb fluid and electrolytes is still impaired.
For anyone with an ileostomy, it’s generally recommended to choose a drink with electrolytes, pay more attention to symptoms of dehydration and to avoid too much plain water.
Clinicians often advise Lucozade sport, but when you understand the science and read the rest of this article you’ll realise there are many other better options… so stay with me.
Symptoms of sub-optimal hydration can include:
- Fatigue/low energy
- low blood pressure
- feeling groggy
- fuzzy head or headache
- difficulty concentrating
- yellow urine
Dehydration occurs on a spectrum and signs of more serious dehydration* include
- Very dark urine
- Severe dizziness
- dry mouth and skin
- severe headache
- feeling faint or actual fainting
- very low blood pressure
*if you experience these symptoms, please seek medical attention.
So which drink to choose?
The electrolyte drink market is a confusing minefield, filled with influencers, celebrities and inaccurate claims.
To make sense of it it’s important to first understand the science of electrolytes and fluid absorption.
Choosing the right drink is essential and all electrolyte drinks are NOT the same.
The science of the sodium/glucose co-transport system underpins optimal hydration.
Put simply, a drink must have a bit of glucose (labelled as carbs) AND a bit of sodium. Other stuff (like potassium and magnesium) can also be important, but sodium and glucose should be the focus.
- The presence of both glucose (carbs) AND sodium in a drink is essential for optimum absorption of fluid into the cells. This is something known as the sodium glucose co-transport system which is a bit like creating a supercharge for water.
- Potassium is also important in the right amounts although it doesn’t influence fluid absorption, it is important to replace it as its’ lost through stoma output.
- There are optimum levels of sodium and glucose as recommended by the World Health Organisation (WHO) for oral rehydration drinks. Detailed in the chart below.
- Many commercial drinks do NOT fall into these recommended ranges. It’s essential to look at the ingredients and concentrate on the levels of sodium and glucose.
- Many drinks have ZERO sugar/glucose (check the ingredients!) things like High 5 Zero and Nuun – whilst these might seem like the ‘healthy’ choice, they’re not. Firstly they don’t have the essential levels of glucose for absorption and they often have artificial sweeteners. Avoid them and choose something with a little bit of glucose instead for more effective absorption.
- Others have TOO MUCH glucose and NOT ENOUGH sodium – as in the case of something like Lucozade sport
- Choose different drinks for different situations. Things like convenience, weather, exercise, stoma output, situation, taste, cost, will all influence what you drink and when
- You can ask your GP for a prescription of Dioralyte
- Adapt your fluid intake to your daily needs and the conditions
Comparison chart
I got a bit geeky and created this chart to show the comparison of a range of drinks … values are for a drink made up to 500ml.
When choosing a drink look at the sodium and carbs levels as priority and compare them to the WHO range in the chart.
Quick check range – to be effective your drink should have the following per 500ml
- Carbs 5-17g
- Sodium 460-1035mg
Read the label of your drink and simply check carbs and sodium fall into the above range.
You can see that the only drinks on the chart that fall into the WHO range are Dioralyte, SOS rehydrate and Precision Hydration 1500.
Others come close, some are way out. That doesn’t mean they’re bad, but there may be more effective options. There may be other drinks that fall into the WHO range, please check the labels and do your own comparison.
Choose something that’s in the WHO range (or close to range as possible) as your baseline for daily drinking. You can’t go wrong with Dioraltye on a daily basis.
If your product isn’t on this list, don’t worry. All you need to do look at the ingredients, calculate what it should be for 500ml and compare it to the WHO recommendations.
Ideally drink something within the WHO range most of the time, especially in special circumstances, which could include:
- Hot temperatures – when you sweat more, but also sodium is needed to help control body temperature
- During exercise when you’re sweating more
- If your stoma is watery output or sporadic
- During travel – especially prolonged air travel or in air conditioning
- Experiencing symptoms of ‘sub optimal’ hydration – don’t wait to feel fully dehydrated!
Daily routine top tips
Everyone is different, so it’s important to find hydration strategies that work for you and your personal circumstances and health.
- Aim for 500-1000ml of electrolyte fluid per day as a baseline.
- Limit plain water to 500ml per day – too much can flush out electrolytes – very pale urine and frequent urination is a sign of over drinking
- Have a range of mixed fluids as well – including juices, squashes, tea, coffee, cordials etc
- During exercise – choose a product more specific for sports – my go to is Precision Hydration 1500 sachets. 500ml per hour if hot or sweating lots
- During hot weather – increase fluids as needed and monitor signs and symptoms of dehydration and overheating
- If you have other medical conditions, especially kidney or cardiac problems, please speak to your doctor or health care provider and take their advice
Summary
Cut through the marketing and influencers and understand the science behind it.
Not all electrolyte drinks are the same.. start reading labels, check ingredients and levels and compare to the chart.
If you have a very high output stoma or need more medical advice, please speak with your doctor about the recommendations in this article.
More resources
Article Why hydration matters with an ileostomy
YouTube video from a Facebook Live event – Sarah Russell – Hydration with a Stoma (Facebook Live – 13/05/2020)
Research papers
Sarah Russell MSc – Clinical Exercise Physiologist – www.theostomystudio.co.uk
