What's the rationale behind drinking lots of water on Riba?

I've always heard it's recommended to consume lots of water while on treatment -- individuals, support groups, treatment nurses, you wonderful folks here -- I've heard many say that, but I'm just wondering if there's an actual science behind it.  The reason I pose the question is because my husband is also (on the flip side) trying to keep to low salt and 'moderate' fluid intake because he's cirrhotic and has had trace acities in the past (which seemed to have resolved, thankfully).  Part of me wants to encourage him to drink more water (as his tx nurse stresses) because I've also heard it makes so many feel better while in treatment, but part of me thinks he's doing what his body feels is right in consuming fluids in moderation (which is in the handbook the TP hep doc gave him).  Any thoughts appreciated.

[jmjm530]

What does the transplant doc think? I'd start with that. Treatment is dehydrating and therefore the general recommendation is to drink half you weight in ounces of water. So if you weigh 100 pounds, that would be 50 ounces of water over a 24-hour period.

[Trish77]

What Jim said, about it dehydrating you.  Having said that, I confess I didn't drink nearly as much water as recommended.  I kept an eye on my urine and if it was getting darker yellow, I drank more water.  If I started getting headaches, I knew I wasn't consuming enough (same principle as hangovers - dehydration constricts the blood vessels, causes headaches).  Could see ridges on my fingernails - dehydration, drink more water.  That kind of thing.  I did it more symptomatically than by a formula.  Not saying that's a good way to go.  Just sharing from someone who always found it hard to drink alot of water. I also drank alot of coffee while on treatment.  Doubt I could have managed my workday without it.

[jmjm530]

Trish: I also drank alot of coffee while on treatment
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Coffee counts toward the water requirement which would more accurately be called a fluid requirement.  So do other fluids such as juice, milk, soda, etc.

[Trish77]

Fluid requirement would be more accurate, yes.  My point was that I didn't base it on a formula but went more on symptomatic requirements.  Not a recommendation on my part, just a comment for others like me who found it hard to consume the suggested amount of fluids.

[Rockerforlife]

Belive it of not...i dont even drink water...afetr all the blueberry juice and green powered spirlina drinks and organicc tea....no room left for water....and im not dead yet

[newleaf09]

Talk to doc about your special circumstances.  Both riba and interferon are dehydrating, causing your cells to use more than normal water.  The extra water is just trying to keep up with the extra use.  Many of the side effects, like leg cramps, headache and, to some extent, rash can be improved with increased water intake.  We drink so much water it would make a normal person sick, but not someone who's dehydrated.

[jmjm530]

We weren't in disagreement, not with my SVR girl :) just pointing out that you probably met your fluid requirement even though you weren't counting.

"Although it's a great idea to keep water within reach at all times, you don't need to rely only on what you drink to satisfy your fluid needs. What you eat also provides a significant portion of your fluid needs. On average, food provides about 20 percent of total water intake, while the remaining 80 percent comes from water and beverages of all kinds.

For example, many fruits and vegetables, such as watermelon and tomatoes, are 90 percent to 100 percent water by weight. Beverages such as milk and juice also are composed mostly of water. Even beer, wine and caffeinated beverages — such as coffee, tea or soda — can contribute, but these should not be a major portion of your daily total fluid intake. Water is one of your best bets because it's calorie-free, inexpensive and readily available. "

http://www.mayoclinic.com/health/water/nu00283

[Rockerforlife]

TAP WATER????

[chuckles333]

I believe that caffeine is a diuretic which is any drug that increases the flow of urine through the body. That being said a question is now apparent. We know that if you increase the flow of urine without increasing fluid intake that this would cause additional dehydration (on top of that already caused by treatment) however if you are drinking coffee, tea or caffeinated soft drinks this obviously has a fluid component to it. Is the fluid component in coffee high enough to offset the dehydration caused by the diuretic action and, if so, is it then sufficient to additionally alleviate some of the dehydration caused by treatment? Is coffee, tea, coke etc. considered a plus or minus in fluid intake?

[eureka254]

Thanks for the feedback and discussion.  The quandry is that he has 3 hepatologists: one for hcc follow up, one for TP evaluation, and one for viral hcv, and they all say things a little differently.  (And oftentimes, not as clearly as you folks!)

So perhaps I need to reframe my thinking as "overall fluid balance" rather than hydration or saturation.  Being more of a scientific bent, I've been eyeing the recommended '1/2 your weight in ounces' as the target goal (or less with his condition), but I have to admit my husband works more on the symptomatic method rather than by formulae.  And, similar to Rocker, he almost never drinks water (tap or bottled!) -- it's sometimes juice, but mostly it's caffeinated beverages -- he's a coca cola fanatic -- and he drinks so much of it I think it'd make anyone else sick :).  (He'd probably be so ecstatically happy if someone DID recommend that drinking caffeinated beverages WAS the way to go. lol)

All of which does make me echo the same question posed by chuckles... is over-consumption of caffeinated beverages equivalent to moderate hydration by other fluid intake methods? Maybe it's a win/win that he's drinking so much cola after all?!? :)

~eureka
humming 'trish is SVR, trish is SVR' under her breath

[Rockerforlife]

To me its commonn sense...if your are thirsty...DRINK

[Isobella]

For me, it's kinda obvious too....when my head aches, time to drink more water.  Lately my lips get chapped.  Then I guzzle til they stop.

Eureka.....you're humming my favorite new song =)

[can-do-man]

Heck i thought my hepo just wanted me to have to get up a zillon times a night to pee, stub my toe a few times and bounce off the walls, maybe even trip and fall.... Oh well

[winner727]

yeah ,same thing here. I try to get most of my 3 liters down during the early day . I heard these tx drugs
'dry you up "        

[meakea]

Can-do-man...  Your nightly ritual seems identical to mine.  :)  I think the carpet between my bed and the bathroom has a bit of a path worn in it since I started TX.  :)

[Bill1954]

The first treatment, I drank water per instructions and then some. Second time around, I only drank when I felt thirsty, and I didn’t seem so suffer for it. I don’t really have any answers, just sharing my own experience. I hope hubby does well this time—

Bill

[eureka254]

Thanks for the responses and smiles.  

[nygirl7]

I believe that caffeine is a diuretic .."

You'd have to drink a real lot for it to make that big a difference, as stated above we get plenty of water from lots of sources.  While the "drink half your weight" is the general idea if someone finds it's too much and cuts back without any ill effects - good deal.  Everybody is different and the 'we will get dehydrated" thing is pretty grossly over statedd - except that on treatment out skin hair nails etc all dry out.....

Once my doc said it didn't have to be water and all fluids counted.........it made it a LOT easier to manage. Now these days sitting at my desk I have to just about force myself to remember to drink - think I od'd fluids on tx and now I hardly like them any longer.

As to being cirrhotic - definitely ask your doctor, that is a whole different ball of wax and we'd all hate to be wrong on that one.

[Rockerforlife]

Why not just get one ot thoses  IV drips things on wheels and have the water pumped straight into you...no need to go the washroom either...just gata pan on wheels to tow along

[eureka254]

nygirl7:  the treatment doc says as long a he maintains a low sodium diet, lots of fluid is good... but one can only lead a horse to water.  (The family trough contains only cola and juice.)

(eureka steals the iv drip on wheels used for today's transfusion, swipes a pan and catheter, and ships it special delivery to rocker... and in fair exchange provides his address to carpet-layers so they can remove his wall-to-wall and deliver it to meakea who really needs it...)

[Mr Liver]

"Is the fluid component in coffee high enough to offset the dehydration caused by the diuretic action and, if so, is it then sufficient to additionally alleviate some of the dehydration caused by treatment? Is coffee, tea, coke etc. considered a plus or minus in fluid intake? "

It's a definite plus according to several studies on the topic. The slight diuretic effect of caffeine does not affect the hydration properties of the fluid in any meaningful way .
Personally, I question how much tx makes someone 'dehydrate'. Thirsty ? Yes. Extremely so in many. But to dehydrate you have to lose fluid obviously. I have never seen excessive sweating or urination on the warning labels of any tx med used . Any loss of fluids due to changes in diet could be made up fairly easy without engaging in excessive fluid intake  If you like coffee you have hit the jackpot . Not only counts towards intake totals but its also good for your liver.
Water itself is a natural diuretic. Just ask any beer drinker. :)
ML