Evaluation of Changes in Serum Sodium and Potassium Following Ileostomy and Colostomy

Abstract

Maintenance of normal fluid-electrolyte balance is desirable for maintenance of homeostasis. Much is now known about the metabolism of sodium and potassium and their effects on the body when these electrolytes are deficient. Their loss through skin, kidney and bowel has been studied. But less is known about their excretion through artificially created stoma of the bowel. Further not much work was done in this respect in this rural part of the West Bengal with extreme climate and great swing in temperature dryness. This compounds the problem of such patients due to increase losses of fluid and electrolytes through the skin and lungs. In our study we estimated serum electrolytes, namely serum sodium and serum potassium post operatively at 24hrs (1 st post operative day), 72 hrs (3 rd post operative day) and 120 hrs (5 th post operative day) during the post operative study period, no patient expired and all the patients resuscitated adequately in pre operative period, and maintained an adequate urine output. All the patients in this study had their stoma created on operation for emergency condition. We concluded that patients having high output ileostomy (≥1000ml/day), there was a significant decrease in serum sodium and serum potassium on 5 th post operative day. And we recommend that all patients who undergo ileal resection along with ileostomy, or who have high ileostomy output, should be closely monitored for electrolyte derangement from the 3 rd post operative day onwards.