Thirst - excessive

Definition

Excessive thirst is an abnormal feeling of always needing to drink fluids.

Alternative Names

Increased thirst; Polydipsia; Excessive thirst

Considerations

Drinking lots of water is usually healthy. However, the urge to drink too much may be the result of a physical or emotional disease. Excessive thirst may be a symptom of high blood sugar (hyperglycemia). It can be an important clue in detecting diabetes.

Excessive thirst is a fairly common symptom. It is often the reaction to fluid loss during exercise, or to eating salty foods.

Common Causes

• A recent salty or spicy meal
• Bleeding enough to cause a significant decrease in blood volume
• Diabetes
• Diabetes insipidus
• Drugs such as anticholinergics, demeclocycline, diuretics, phenothiazines
• Excessive loss of water and salt (possibly due to not drinking enough water, profuse sweating, diarrhea, or vomiting)
• Loss of body fluids from the bloodstream into the tissues due to:
  • Conditions such as severe infections (sepsis) or burns
  • Heart, liver, or kidney failure
• Psychogenic polydipsia, the result of a mental disorder

Home Care

Because thirst is usually the body's signal to replace water loss, it is usually appropriate to drink plenty of liquids.

A very strong, constant urge to drink may be a sign of a psychological problem, which may mean psychological help is needed.

For thirst caused by diabetes, follow the prescribed treatment to properly control blood sugar levels.

Call your health care provider if

• Excessive thirst is persistent and unexplained
• Thirst is accompanied by other unexplained symptoms, such as blurry vision and fatigue
• You are passing more than 5 quarts of urine per day

What to expect at your health care provider's office

The health care provider will get your medical history and perform a physical examination.

Medical history questions may include the following:

• How long have you been aware of having increased thirst?
• Is it consistent during the day?
• Is it worse during the day?
• Did it develop suddenly or slowly?
• Are you eating more salty or spicy foods?
• How much salt do you have each day?
• Did you change your diet?
• Have you noticed an increased appetite?
• Have you noticed an unintentional weight gain?
• Have you noticed an unintentional weight loss?
• Has your activity level recently increased?
• What other symptoms are happening at the same time?
• Have you recently suffered a burn or other injury?
• Are you urinating more or less frequently than usual?
• Are you producing more or less urine than usual?
• Have you noticed any bleeding?
• Are you sweating more than usual?
• Is there any swelling in your body?
• Do you have a fever?

A psychological evaluation may be recommended if the health care provider suspects a psychological compulsive thirst. Your fluid intake and output will be closely watched.

Diagnostic tests that may be performed include the following:

• Blood glucose level
• CBC and blood differential
• Serum calcium
• Serum osmolality
• Serum sodium
• Urinalysis
• Urine osmolality

Prevention

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References

Gibbs MA, Tayal VS. Electrolyte disturbances. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 123.