Acid-base and electrolyte abnormalities with diarrhea or ureteral diversion


Diarrhea (and other losses of intestinal secretions) and ureteral diversion can lead to a variety of acid-base and electrolyte abnormalities. The types of changes in serum chemistries that can occur, the etiology mechanisms, and issues related to diagnosis and treatment will be reviewed here.


Intestinal secretions, including pancreatic and biliary secretions, are relatively alkaline with a total base concentration of 50 to 70 meq/L [1]. The following acid-base and electrolyte abnormalities can be seen:

Metabolic acidosis due to the loss of alkaline fluid.

Metabolic alkalosis due to laxative abuse.

Hypokalemia, which can be induced by diarrhea, a villous adenoma, or the removal of pancreatic, biliary, or intestinal secretions (by tube drainage, fistulas, or vomiting with intestinal obstruction).


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Literature review current through: Jul 2014. | This topic last updated: Jan 14, 2014.
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