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Can you buy a sack lunch at Orisson if you're not a guest there?

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Kasee

Member
Time of past OR future Camino
Sept. 2022
We aren't staying at Orisson, but are planning on having breakfast there. Do they sell sandwiches to go? If they don't, we're prepared to buy bread, cheese, etc in SJPP and make our own lunch at one of our rest breaks on the way to Roncesvalles.
 
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Sirage

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Le Puy to Santiago (2005), Porto to Santiago (2007), Vezelay for 200 kms (2009), From Seville, May (2015), Le Puy to Sangüesa (2016), Norte-Primitivo (Sep-Oct 2016)
It is possible to walk from SJPP to Roncesvalles without eating - all you need is water. Then enjoy your first lunch in Spain.
 
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Time of past OR future Camino
2023
I love language. I especially love how words are repurposed by different communities. I think that it provides insight into the essence of some communities.

A long time ago I went to visit my brother who was living in Redmond, Oregon at the time.

I was born in Fiji but I have lived in Aotearoa New Zealand since I was six. As a result I speak a mix of Kai Viti and Kiwi English that probably sounds odd to some people and having watched many movies made in the USA I think that I understand a bit of USA English.

The day after I arrived in Redmond I went down to the local supermarket to replenish some toiletries and possibly to get a razor to shave my beard.

Anyway, I get the things that I want, put them on the belt for the cashier. She tallies them up, tells me the price and then asks "would you like a sack with that?"

I remember vividly, standing there transfixed, wondering if this was some sort of special promotion where they were giving away sacks if you shopped at this supermarket or if the cashier thought that I was maybe buying a bushel of wheat or was there some other reason why this person thought that I might need a sack at that particular time???

I am not sure how long I stood there, not saying anything, looking at the cashier with bewilderment and probably an open mouth but it seemed like a very long time.

Eventually the cashier grew tired of this and picked up a paper bag, waved it at me and asked again "did you want a sack with that?"

Finally, it clicked for me. In this community they call paper bags "sacks". I relaxed, replied "no thanks", paid the young lady, picked up my items and walked away with a new understanding of language.

@Kasee thank you very much for reminding me of that delightful lesson and I wish you the very best for your upcoming Camino and I hope that you have a nice lunch.
 

Jeff Crawley

Veteran Member
Time of past OR future Camino
A "Tourigrino" trip once Covid has passed, so 2023
@DoughnutANZ: I love language too but English is not my mother tongue so I do not understand your problem with the word sack ... For me it is nothing else than a bag. So please help me out!
In Standard English a sack is usually a large bag - think potatoes

1662038085944.png

or Sint-Nicolaas 😉

Supermarkets usually use shopping or grocery bags

1662038195014.png

Other countries use of English might vary of course.
 

SabineP

Veteran Member
Time of past OR future Camino
some and then more. see my signature.
In Standard English a sack is usually a large bag - think potatoes

View attachment 131955

or Sint-Nicolaas 😉

Supermarkets usually use shopping or grocery bags

View attachment 131956

Other countries use of English might vary of course.


Ah the joy of language.
Here in Flemish Dutch we could also use the dimunitive form.
" Zak" and " zakje" for the big bag of potatoes or the small bag of groceries.
Not to speak about what slang for " zak" means but I am digressing...😉
 
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MichelleElynHogan

Veteran Member
A whole other option would be to walk to Valcarlos where they do have a supermercado / bar / restaurant all in one stop. And, if you're staying in town, the bartender can give you the code for the Albergue doorlock. They meet everyone later to collect payment. And they provide a basic breakfast as well. This is plenty to get through and past Roncesvalles the next day.

Again, a whole other option.
 

pjacobi

Active Member
Time of past OR future Camino
2015, St. Jean Pied de Port to Burgos
2016, Burgos to Ponferrada
2017, Ponferrada to Atlantic Ocean
It is possible to walk from SJPP to Roncesvalles without eating - all you need is water. Then enjoy your first lunch in Spain.

Always carry food! Your body needs more than water. You need salt to replace loss from sweat, and sugar to replace energy that was burned.

Drinking only water can result in water poisoning/intoxication:



-Paul
 
Time of past OR future Camino
2023
@DoughnutANZ: I love language too but English is not my mother tongue so I do not understand your problem with the word sack ... For me it is nothing else than a bag. So please help me out!
I don't have any problem with it. As I said, different communities sometimes use words in very different ways.

I enjoy having my internal world view expanded.

In my local community the word sack has come to mean a very large hessian bag that originally would have been used for carrying bulk items such as 40lb of potatoes.

I am not suggesting that this usage that I am used to is "correct" or better or even more common than any other usage.

I was merely demonstrating my own insularity. I hear this word used in this manner so rarely that it's usage in this thread reminded me of the first time that I came across it used this way.

All languages are fluid and change over time. Different communities often develop their own sub language.

Here in Aotearoa New Zealand this word has developed to have a particular meaning that is relatively specific.

Clearly, in other communities it has retained a more general meaning.

That the meaning of this word has diverged slightly in differing communities is not good or bad. It just is.

There are many other words like this in English and all languages that have differing meanings depending on which communities they are used in. One simple example is the word bathroom. In North America this means what I would call a toilet whereas here bathroom means the room where I wash or bathe.

Again, these differences aren't good or bad, they are just different.

The way that this relates to Caminos comes via travel.

Until I had travelled to Redmond, Oregon I had never encountered its use in this way. As others travel out of their usual communities then they will also encounter things that are different from what they are used to.

To me, this is one of the real benefits of travel, I get to be reminded that the meanings and other aspects of my culture that form the background of how I view the world are not the only meanings that are possible. When I understand this then I can really start to learn.

My post was never designed to upset anyone and if it has then I appologise.

My post was one, a serendipity reaction to seeing this usage of the word sack and two an attempt to gently invite anyone reading it to consider how two similar cultures get to assign different meanings to a common word and in doing so, to start a Camino journey of learning.

My attempt seems to have failed. I will learn from that.

Thank you for raising this.
 

CWBuff

Veteran Member
Time of past OR future Camino
Frances May-June/2022
Finisterre June-July/2022
the very short answer to original question is YES
As stated earlier - it is a bar\Restaurant\Cafe so....
  • sit down inside\outside\on the terrace if you so choose and have a meal
  • order a sandwich 'to go' and anything else you may like
  • a combo of previous 2

Buen Camino!
 

JPL

New Member
Time of past OR future Camino
Camino Portugues 2022
I don't have any problem with it. As I said, different communities sometimes use words in very different ways.

I enjoy having my internal world view expanded.

In my local community the word sack has come to mean a very large hessian bag that originally would have been used for carrying bulk items such as 40lb of potatoes.

I am not suggesting that this usage that I am used to is "correct" or better or even more common than any other usage.

I was merely demonstrating my own insularity. I hear this word used in this manner so rarely that it's usage in this thread reminded me of the first time that I came across it used this way.

All languages are fluid and change over time. Different communities often develop their own sub language.

Here in Aotearoa New Zealand this word has developed to have a particular meaning that is relatively specific.

Clearly, in other communities it has retained a more general meaning.

That the meaning of this word has diverged slightly in differing communities is not good or bad. It just is.

There are many other words like this in English and all languages that have differing meanings depending on which communities they are used in. One simple example is the word bathroom. In North America this means what I would call a toilet whereas here bathroom means the room where I wash or bathe.

Again, these differences aren't good or bad, they are just different.

The way that this relates to Caminos comes via travel.

Until I had travelled to Redmond, Oregon I had never encountered its use in this way. As others travel out of their usual communities then they will also encounter things that are different from what they are used to.

To me, this is one of the real benefits of travel, I get to be reminded that the meanings and other aspects of my culture that form the background of how I view the world are not the only meanings that are possible. When I understand this then I can really start to learn.

My post was never designed to upset anyone and if it has then I appologise.

My post was one, a serendipity reaction to seeing this usage of the word sack and two an attempt to gently invite anyone reading it to consider how two similar cultures get to assign different meanings to a common word and in doing so, to start a Camino journey of learning.

My attempt seems to have failed. I will learn from that.

Thank you for raising this.
Well this just triggered a memory from my childhood...I grew up in the central part of the United States (Indiana), and when it was cold outside, before we went out to play we would put on a sweat sack. This was perfectly normal until I went to college and discovered I was actually wearing a sweat shirt! Apparently, the term sweat sack was a very local thing where I grew up.
 
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Albertagirl

Veteran Member
Time of past OR future Camino
Frances; Aragones; VdlP; Madrid-Invierno; Levante
I recall my first camino, when I had booked my first night at Orisson. After I arrived there, fairly early in the day, I sat down on the roadside terrace and ordered a beverage. There were one or two couples on the spacious terrace, besides myself. I was thrown out, told that I could go inside and order a drink at the bar. The terrace was reserved for meal buying customers. Somehow, that experience, and a couple of others, in the crowded bedroom at Orisson and along the trail to Roncesvalles, coloured my view of that route. I have never desired to walk the Napoleon again. And I had been walking mountain trails with delight for many years. Oddly, I think that Orisson was too communal for me. This year, I am walking the San Salvador.
 

CWBuff

Veteran Member
Time of past OR future Camino
Frances May-June/2022
Finisterre June-July/2022
and BTW - technically speaking there is absolutely NOTHING that precludes you from grabbing something in SJPdP and taking it with you regardless of what you will do at Orisson.
If you are set on hoofing it up to Roncesvalles in one day then perhaps consider all options
  • Get some sandwich and or fruit(s) in St Jean (I stayed in Beilari and had them make me a very nice sandwich which I devoured probably 2/3-way to Orisson ... and thats after eating breakfast there and with the fact that Orisson was my stage end for the day)
  • Get some lunch at Orisson (and dont forget your sello... technically tampone)
  • Get something 'light' (fruit, drink, boiled egg, etc.) at the food truck (and dont forget your sello... hmmm perhaps still tampone)
  • if you have any food left have a break at Col Lepoderer
 

biarritzdon

Veteran Member
Time of past OR future Camino
CF11, CF12, CP13, CF14, CA15, S.Anton15, CF&CI15
Ditch Pig16, CF&CP17, CdN18, CM18, CF18, LePuy19
The sack discussion from Doughnut ANZ reminds me of an experience I had after I moved back to the US from living in francophone West Africa for 4 years. In West Africa, as in most of the developed world today, you take your own shopping bag to the supermarket, I went to a grocery in the US with my bag and was confronted with a slangy ebonic question, "pay..pour..plastic?" I said, no I have my own bag and I will pay with cash not a credit card. Only then did I realize they were asking if I wanted a paper bag or a plastic bag and it was not a question regarding the form of payment I planned to use.
 
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CWBuff

Veteran Member
Time of past OR future Camino
Frances May-June/2022
Finisterre June-July/2022
I recall my first camino, when I had booked my first night at Orisson. After I arrived there, fairly early in the day, I sat down on the roadside terrace and ordered a beverage. There were one or two couples on the spacious terrace, besides myself. I was thrown out, told that I could go inside and order a drink at the bar. The terrace was reserved for meal buying customers. Somehow, that experience, and a couple of others, in the crowded bedroom at Orisson and along the trail to Roncesvalles, coloured my view of that route. I have never desired to walk the Napoleon again. And I had been walking mountain trails with delight for many years. Oddly, I think that Orisson was too communal for me. This year, I am walking the San Salvador.
WOW!!! To be honest I do not recall if I actually DID order the beverage (Basque Cider) at the bar...but I do know that I was on the terrace when the girl brought it to me and i enjoyed it and there were many other folks on the terrace at that moment.
Orisson is sort of hit or miss - some folks have no issues and some.... well... seems it all may depend on the mood-du-jour of Madame Carole....
Here is to many different ways to walk the Camino! May we all enjoy our refreshments and look forwards to the destination
Ultreia!
 

trecile

Moderator
Staff member
Time of past OR future Camino
PAST - Francés, Norte, Salvador, Portuguese
I recall my first camino, when I had booked my first night at Orisson. After I arrived there, fairly early in the day, I sat down on the roadside terrace and ordered a beverage. There were one or two couples on the spacious terrace, besides myself. I was thrown out, told that I could go inside and order a drink at the bar. The terrace was reserved for meal buying customers. Somehow, that experience, and a couple of others, in the crowded bedroom at Orisson and along the trail to Roncesvalles, coloured my view of that route. I have never desired to walk the Napoleon again. And I had been walking mountain trails with delight for many years. Oddly, I think that Orisson was too communal for me. This year, I am walking the San Salvador.
It could have been the time of day that you were there and/or because you weren't staying there.
Every time that I've stayed at Orisson I've enjoyed a glass of wine out on the terrace with other pilgrims without buying a meal. But it was later in the afternoon outside of regular meal times.

In addition to pilgrims, Orisson does also have a local clientele that drives up there for lunch.
 

biarritzdon

Veteran Member
Time of past OR future Camino
CF11, CF12, CP13, CF14, CA15, S.Anton15, CF&CI15
Ditch Pig16, CF&CP17, CdN18, CM18, CF18, LePuy19
Trecile,
While I was living in Biarritz there were several of us Camino addicts who would drive down there on a bright, clear day for the view, lunch, wine and a Camino fix; meanwhile having a laugh cruelly cheering on struggling pilgrims on their first day.
 
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Albertagirl

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Frances; Aragones; VdlP; Madrid-Invierno; Levante
the policy is understandable.
Certainly. I understood it. I just felt like I wasn't welcome and I wouldn't want to return. I suppose that the pilgrims passing through are so many that one fewer is insignificant. But then, first impressions in a location that offers hospitality can easily drive away customers. Orisson has its regulars and I have many other caminos still to walk.
 
Time of past OR future Camino
Camino Frances 2021
Fisterra 2021
Always carry food! Your body needs more than water. You need salt to replace loss from sweat, and sugar to replace energy that was burned.

Drinking only water can result in water poisoning/intoxication:



-Paul
I will not disagree with the body needing food and drink, but water intoxication is not a real issue unless someone is drinking distilled water only. Sweat losses are primarily water, not salt. Water needs to be replaced. I can supply you with the medical literature on this if you would like.

Now, if you were to drink 20 liters of water then water intoxication might become a reality.
 
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SabineP

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Time of past OR future Camino
some and then more. see my signature.
I will not disagree with the body needing food and drink, but water intoxication is not a real issue unless someone is drinking distilled water only. Sweat losses are primarily water, not salt. Water needs to be replaced. I can supply you with the medical literature on this if you would like.

Now, if you were to drink 20 liters of water then water intoxication might become a reality.

Thank you! The wikipedialink is absolutely not relevant in terms of a Camino imo.
So yes it would be interesting if you could provide objective links 🙂.
 
Time of past OR future Camino
2012
I’m minded off the second best joke from W C Fields repertoire as to why he would never drink water. The internet will provide. There’s no need for me to breach forum rules. Students meanwhile may wish to parse “someone stole the cork from my lunch” and why “it was a kind woman…. and I forgot to thank her” has remained my guiltiest secret for so many years
 
Time of past OR future Camino
Camino Frances 2021
Fisterra 2021
Thank you! The wikipedialink is absolutely not relevant in terms of a Camino imo.
So yes it would be interesting if you could provide objective links 🙂.
In 31 years of being an ER doc I have only seen two cases of water intoxication and both were patients with schizophrenia whose voices told them to purify themselves with pure (ie, distilled) water. They both overwhelmed the bodies attempt to correct things. Required ICU management to come out alive.

In regards to fluid choices, these are some pages from UpToDate:

Hydrate before activity and keep well hydrated throughout activity. Before training and competition in the heat, athletes should drink 6 mL of fluid per kg of body mass every two to three hours in order to begin exercise properly hydrated. We begin this process approximately four to six hours prior to the start of training or competition. Of note, unless an athlete is deficient in sodium and other electrolytes, increased salt intake before and during exercise is unlikely to help prevent exertional heat illness.

It is important to note that during exercise free water losses exceed electrolyte losses, leading to elevated serum sodium concentrations, unless these losses are replaced. However, sodium concentrations in sweat vary widely among athletes and there may be a subset with high concentrations (so-called "salty sweaters") [56,60].

Stofan JR, Zachwieja JJ, Horswill CA, et al. Sweat and sodium losses in NCAA football players: a precursor to heat cramps? Int J Sport Nutr Exerc Metab 2005; 15:641

Godek SF, Peduzzi C, Burkholder R, et al. Sweat rates, sweat sodium concentrations, and sodium losses in 3 groups of professional football players. J Athl Train 2010; 45:364.
 
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Time of past OR future Camino
Camino Frances 2021
Fisterra 2021
Thank you! The wikipedialink is absolutely not relevant in terms of a Camino imo.
So yes it would be interesting if you could provide objective links 🙂.
A bigger partial chapter from UpToDate in regards to Fluids and Dehydration. Written by Dr Richard Stern.

It is very long. Ignore if not interested.

PATHOGENESIS OF AND DEFENSE AGAINST HYPOTONIC HYPONATREMIA

Hypotonic hyponatremia results from the intake (ie, oral, intravenous, other absorption) and subsequent retention of water [3,5-7].

The major defense against hyponatremia is the capacity to excrete large volumes of urine with a low concentration of sodium and potassium (ie, electrolyte-poor water):

●When water is ingested or absorbed causing even slight hypotonicity, both thirst and antidiuretic hormone (ADH; also called vasopressin) release are normally suppressed [8]. ADH is produced by hypothalamic neurons that receive inputs from osmoreceptors that respond to the serum sodium concentration and from baroreceptors that respond to the status of the circulation [9]. Suppression of ADH secretion requires normal functioning of osmoreceptors and the absence of signals from baroreceptors that can stimulate ADH release even when the serum sodium concentration is low.

●Excretion of electrolyte-poor water is accomplished by reabsorbing salt without water in the water-impermeable ascending limb of the loop of Henle and distal convoluted tubule (known as diluting sites) [10]. Excretion of electrolyte-poor water also requires that the renal tubule segments beyond the diluting sites (the later distal tubule segments and collecting duct) are relatively impermeable to water; water impermeability of these sites requires that the epithelium contain very few water channels (aquaporins). High levels of ADH result in insertion of water channels in the collecting duct while low levels of ADH allow these water channels to be removed from the epithelium [5].

Thus, a water load will, in normal individuals, be rapidly excreted as the dilutional fall in serum tonicity suppresses the release of ADH (figure 1), thereby allowing excretion of the excess water in a dilute urine.

The maximum attainable urine volume in normal individuals on a regular diet is in excess of 10 L/day. The normal diluting mechanisms of the kidney can produce urine with an osmolality that is at least as low as 100 mosmol/kg and often as low as 50 mosmol/kg. A typical western diet generates approximately 900 mosmol of solute daily, which is composed of approximately one-half urea (derived from dietary protein) and one-half sodium and potassium salts. On such a diet, urine with an osmolality of 50 mosmol/kg has a sodium plus potassium concentration of approximately 12 mEq/L. Excretion of 900 mosmol of solute at a concentration of 50 mosmol/L will result in 18 L of electrolyte-poor urine. If the diet is lower in salt, potassium, and protein, the capacity to excrete large volumes of urine will be less. As an example, excretion of 300 mosmol of solute at a concentration of 50 mosmol/L will result in only 6 L of electrolyte-poor urine. However, this still provides an enormous range of protection against the development of hyponatremia since the daily fluid intake in most healthy individuals is less than 2 to 2.5 L/day.

In contrast to the response in normal individuals, patients who develop hyponatremia typically have an impairment in renal water excretion, most often due to an inability to suppress ADH secretion [11]. An uncommon exception occurs in patients with primary polydipsia who can become hyponatremic because they rapidly drink such large quantities of fluid that they overwhelm the excretory capacity of the kidney even though ADH release is appropriately suppressed. (See 'Primary polydipsia due to psychosis' below.)


CLASSIFICATION OF HYPOTONIC HYPONATREMIA

Hyponatremia occurs when water intake exceeds water excretion; it can result from water intake that is large, water excretion that is low, or a combination of these abnormalities. Because excretion of electrolyte-poor water is the normal defense against hyponatremia, we classify the causes of hyponatremia according to the body's ability to excrete dilute urine and, if that is impaired, the reason for the impairment.

Other classification systems divide hyponatremia into hypovolemic, hypervolemic, and euvolemic hyponatremia. However, determining a patient's volume status is often difficult (particularly distinguishing hypovolemia and euvolemia). In addition, classification of hyponatremia by volume status is most helpful in defining the reason for failure to suppress antidiuretic hormone (ADH) secretion. (See 'Impaired urine dilution due to unsuppressed ADH secretion' below.)

Unimpaired urine dilution

Primary polydipsia due to psychosis
— Primary polydipsia, a disorder in which there is a primary increase in thirst, is most often seen in patients with psychiatric illnesses [12-17]. As an example, one study of 239 hospitalized patients with mental illness found that 6.6 percent had a history compatible with compulsive water drinking and that one-half of these had intermittent symptoms of hyponatremia due to transient water retention [18].

It is presumed that a central defect in thirst regulation plays an important role in the pathogenesis of polydipsia [15,19]. In some cases, for example, the osmotic threshold for thirst is reduced below the threshold for the release of ADH [20]. In contrast to normal subjects in whom the thirst threshold is roughly equal to or a few mosmol/kg higher than the threshold for ADH [21], these patients will continue to drink until the plasma osmolality is less than the threshold level. This may be difficult to achieve, however, since ADH secretion will be suppressed by the fall in plasma osmolality, resulting in rapid excretion of the excess water and continued stimulation of thirst. The mechanism responsible for abnormal thirst regulation in patients with primary polydipsia is unclear.

Normal subjects can excrete more than 400 to 600 mL of urine per hour, a response that is mediated by suppression of ADH secretion and the subsequent formation of a dilute urine with a minimum osmolality between 40 and 100 mosmol/kg. If ADH regulation and kidney function are intact, primary polydipsia should not lead to clinically important disturbances in the plasma sodium concentration without a massive increase in water intake. Thus, the serum sodium concentration is usually normal or only slightly reduced in primary polydipsia since the excess water is readily excreted [13]. These patients may be asymptomatic or present with complaints of polydipsia and polyuria. (See "Evaluation of patients with polyuria".)

Water intake may occasionally exceed 400 to 600 mL per hour, particularly in institutionalized patients with severe psychosis [17] and may produce fatal hyponatremia even though the urine is maximally dilute with an osmolality below 100 mosmol/kg [22,23]. Symptomatic hyponatremia can also be induced with an acute 3- to 4-liter water load. This is sometimes seen in anxious patients preparing for a radiologic examination or in those attempting to dilute their urine to avoid a positive urine drug test [24].

However, some patients with polydipsia who become hyponatremic have a higher urine osmolality than polydipsic patients who remain normonatremic, indicating a concurrent increase in ADH release and/or response [12,19,25,26]. A number of different abnormalities in ADH regulation have been identified in psychotic patients, each of which can impair water excretion. Studies in patients who have had at least one episode of hyponatremia have revealed the following defects [19]:

●Transient stimulation of ADH release during acute psychotic episodes, producing the syndrome of inappropriate ADH secretion (SIADH) [25,27].

●An increase in the net renal response to ADH so that, at the same plasma ADH levels, psychotic patients have a higher urine osmolality and therefore a lower rate of free water excretion than healthy controls [19]. How this occurs is not known.

●Antipsychotic or antidepressant drugs (such as fluoxetine) may also produce SIADH in a few patients. As examples, carbamazepine and fluoxetine can produce hyponatremia with an SIADH-like clinical picture [28,29].

●A downward resetting of the osmostat regulating ADH release. As a result, a lower-than-normal plasma sodium concentration is required to completely suppress ADH release and excrete a water load. (See "Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat".)

●Transient ADH release due to nausea [17].

The net effect is that some modestly hyponatremic patients with primary polydipsia do not dilute their urine maximally, as would be expected if ADH were suppressed by hypoosmolality [19]. The likelihood of developing hyponatremia will be increased further by the presence of a cause for enhanced ADH release, such as nausea, stress, or concurrent diuretic therapy [24,30].

Primary polydipsia can also occur with hypothalamic lesions that affect the thirst center, as can be seen with infiltrative diseases such as sarcoidosis [31]. Low dietary solute intake can contribute to the development of hyponatremia by limiting water excretion even if the secretion of ADH is appropriately suppressed. (See 'Low dietary solute intake' below.)

As in any patient with polydipsia and polyuria, the possibility of diabetes insipidus should be considered in patients with psychiatric illness who present with these symptoms in the absence of hyponatremia. If compliance is possible, we recommend a water restriction test to distinguish between primary polydipsia and diabetes insipidus. An alternative in the uncooperative patient is to increase the plasma osmolality via a slow infusion of hypertonic saline with concomitant measurement of copeptin levels. (See "Evaluation of patients with polyuria".)

Measuring the urine osmolality is also important in polydipsic patients who are hyponatremic. Pure primary polydipsia should be associated with appropriate suppression of ADH release and a urine osmolality below 100 mosmol/kg. A higher urine osmolality, which is often present, suggests at least a contributory role for increased ADH release or responsiveness [12,19,26]. (See "Diagnostic evaluation of adults with hyponatremia".)

There is no proven specific therapy for primary polydipsia with or without hyponatremia in psychotic patients. Acutely, limiting water intake will rapidly raise the plasma sodium concentration as the excess water is readily excreted in a dilute urine. The risk of inducing osmotic demyelination in this setting is unclear [32,33].

Over the long term, limiting the use of drugs that cause dry mouth, restricting fluid intake, and frequent weighing (to detect water retention) all may be helpful. Some clinicians have tried the tetracycline derivative demeclocycline, which induces reversible ADH resistance; however, this agent has not generally been effective [34]. (See "Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat"

  1. Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med 2000; 342:1581.
  2. Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorders, 5th ed, McGraw-Hill, New York 2001. p.720.
  3. Yeates KE, Singer M, Morton AR. Salt and water: a simple approach to hyponatremia. CMAJ 2004; 170:365.
  4. Verbalis JG, Goldsmith SR, Greenberg A, et al. Hyponatremia treatment guidelines 2007: expert panel recommendations. Am J Med 2007; 120:S1.
  5. Chung HM, Kluge R, Schrier RW, Anderson RJ. Clinical assessment of extracellular fluid volume in hyponatremia. Am J Med 1987; 83:905.
 
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Hello fellow pilgrims, I’ve just arrived in SJPP and my plan was to set off for Roncesvalles tomorrow morning via the Napoleon route, potentially stopping at Orisson for the night. However, the...
Sad the report that on my second day on the Camino someone stole my GORE-TEX jacket from a table just behind me. Fluorescent yellow cycling jacket marked GORE on the outside in small black...
https://www.diariodenavarra.es/noticias/navarra/zona-norte/2022/09/27/rescatados-dos-peregrinos-hipotermia-ibaneta-542792-1009.html I'll be there in 3 weeks, hopefully adequately prepared.

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