Water and electrolyte balance has been studied in 39 patients with a permanent ileostomy, who had had a proctocolectomy for ulcerative colitis. The findings have been compared with those in 39 healthy subjects who were matched for age and sex. The ileostomists were found to lose excessive quantities of water and sodium in the ileostomy effluent compared with the corresponding losses in normal faeces. The mean plasma total protein and albumin concentrations were increased in the ileostomists suggesting a state of chronic dehydration. The daily urinary output of sodium was low and the output of potassium was high. The urinary pH was low. The ileostomists had raised mean concentration of aldosterone in the plasma (p less than 0.001) and it is suggested that this is responsible for the body's partial compensation for the depletion of sodium and water, including the so-called ileostomy adaptation.
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