What is the cause of a 53-year-old male's complaint of xerostomia (dry mouth) and polydipsia (excessive thirst) following consumption of Powerade (electrolyte-rich sports drink)?

From the Guidelines

The patient should immediately increase water intake with at least 16 ounces of plain water within the next hour, followed by continued hydration throughout the day, as the high sugar content in Powerade can exacerbate dehydration symptoms. The extreme dry mouth and thirst after drinking Powerade in this 53-year-old male could be due to several causes, including paradoxical dehydration from high sugar content, medication side effects, or an underlying medical condition like diabetes. According to a recent study on oral rehydration solutions 1, commercially prepared oral rehydration solutions (ORS) are preferred over sports drinks like Powerade, as they have a higher sodium content and lower sugar content, which can help enhance absorption and reduce secretion.

Some key points to consider in this scenario include:

• The high sugar content in Powerade can draw water into the digestive system through osmosis, potentially worsening dehydration symptoms
• Medications like antihistamines, antidepressants, and blood pressure medications can cause dry mouth, so reviewing current medications with a healthcare provider is important
• Extreme thirst can be a cardinal symptom of hyperglycemia, which requires prompt medical attention
• If this symptom occurs repeatedly after consuming sugary beverages, it would be prudent to have blood glucose levels checked

It is essential to note that the study on oral rehydration solutions 1 highlights the importance of using glucose–electrolyte oral rehydration solutions to enhance absorption and reduce secretion, rather than relying on sports drinks or hypotonic fluids. Therefore, increasing water intake and considering an oral rehydration solution would be the best course of action to address the patient's symptoms.

From the Research

Possible Causes of Dry Mouth

• Xerostomia, the subjective feeling of oral dryness, can be caused by various factors such as Sjögren's syndrome, medication, and radiotherapy to the head and neck 2
• Certain classes of drugs can induce hyposalivation and/or xerostomia by targeting neurotransmitters and receptors, leading to reduced production of fluid and electrolytes in salivary glands 2
• Hyposalivation is the actual decrease in measured salivary outflow, which can be caused by various factors including medication and medical conditions 3

Relation to Powerade Consumption

• There is no direct evidence in the provided studies to suggest that Powerade consumption can cause dry mouth or xerostomia
• However, it is possible that the ingredients in Powerade, such as sugar and artificial sweeteners, may exacerbate dry mouth symptoms in some individuals

Treatment Options

• Saliva substitutes, mouth rinses, sugar-free candy, and pilocarpine are some of the treatment modalities available for xerostomia and hyposalivation 3
• Polymer-based saliva substitutes have been studied as a potential treatment for xerostomia in patients with Sjögren's syndrome, but their efficacy is limited 4
• The optimal properties of a saliva substitute may vary depending on individual factors such as salivary flow rate 4
• Comprehensive investigation of saliva replacement liquids has shown that current products have significant differences in physicochemical properties compared to natural saliva, and may not be effective in alleviating xerostomia 5