Changes in Serum Electrolytes Following Permanent or Temporary Ileostomy

Abstract

Background: Patients with ileostomies are well known to be susceptible to extracellular fluid volume depletion as a result of fluid and solute losses that are greater than intake. However, electrolyte disorders accompanying these episodes of volume depletion are not well delineated.

Objective: To find out serum electrolytes changes observed in patients undergone permanent or temporary ileostomy.

Method: This prospective observational study was carried out in the Department of Colorectal Surgery, BSMMU, Dhaka, from January 2018 to December 2018. Fifty patients underwent permanent or temporary ileostomy and postoperatively treated with intravenous fluid and electrolytes at least up to 3rd POD along with gradual resumption of oral intake or ileostomy feeding and managed at least for 5 days were included in this study. Electrolyte was measured preoperatively and 3rd and 5th POD and observed the changes.

Result: Males were predominant than females (1.17:1). Most of the patients were in age group 31 – 40 years. Mean age was 42.4±12.5 years. Serum sodium (Na) and serum potassium (K) were reduced at POD 3 and at POD 5 compared to pre-operative level. Serum sodium concentration was 136.6±3.75 mmol/L pre operatively and reduced to 135.1 ±2.98 mmol/L at 3rd POD and 134.8±3.04 mmol/L at 5th POD. Similarly, serum potassium concentration was 4.0±0.49 mmol/L pre operatively and reduced to 3.8±0.70 mmol/L at 3rd POD and 3.8±0.50 mmol/L at 5th POD. Both serum Na and serum K level reduced significantly in POD 3 and in POD 5 in comparison to pre-operative values (p<0.05). Regarding serum Cl and serum HCO3 level no statistically significant difference were observed (p>0.05).

Conclusion: Serum sodium and potassium concentration reduced statistically significantly after permanent ileostomy.

Bangladesh Med Res Counc Bull 2021; 47(1): 78-81