Abstract
Six patients with jejunostomies and residual jejunal lengths of 105 to 250 cm took the same food and water each day for eight study days. In random order, three methods of salt replacement were tested, each over 48 hours, against a period without added salt. During the three test periods the patients took 120 mmol of sodium chloride daily, as salt in gelatine capsules, as an isotonic glucose electrolyte (280 mOsmol/kg; 30 kcal) solution, and as a glucose polymer (Maxijul) solution (280 mOsmol/kg; 200 kcal). The daily stomal output remained constant for each patient during the four test periods but varied between patients from 0.60 to 2.84 kg (daily intestinal fluid balance 0.74-2.61 kg). Without a salt supplement, three patients lost more sodium from the stoma than they took in by mouth (-25, -94, and -101 mmol/day) and the mean sodium balance for all six subjects was -16 mmol (range -101 to 79) daily. Extra salt was absorbed with each form of supplement (p less than 0.05); no patient with the glucose electrolyte solution (mean 96, range 0 to 226 mmol), but one patient with the glucose-polymer solution (mean 96, range -25 to 164 mmol) and two with the salt capsules (mean 66, range -8 to 145 mmol) were in negative balance. Two patients vomited with the salt capsules. There was only a small increase in energy absorption (mean 115 kcal) with the glucose polymer solution compared with the glucose electrolyte solution. A sipped glucose electrolyte solution seems to be the optimal mode of sodium replacement in patients with a high output jejunostomy.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Avery M. E., Snyder J. D. Oral therapy for acute diarrhea. The underused simple solution. N Engl J Med. 1990 Sep 27;323(13):891–894. doi: 10.1056/NEJM199009273231307. [DOI] [PubMed] [Google Scholar]
- Fordtran J. S. Stimulation of active and passive sodium absorption by sugars in the human jejunum. J Clin Invest. 1975 Apr;55(4):728–737. doi: 10.1172/JCI107983. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Griffin G. E., Fagan E. F., Hodgson H. J., Chadwick V. S. Enteral therapy in the management of massive gut resection complicated by chronic fluid and electrolyte depletion. Dig Dis Sci. 1982 Oct;27(10):902–908. doi: 10.1007/BF01316574. [DOI] [PubMed] [Google Scholar]
- MILLER D. S., PAYNE P. R. A ballistic bomb calorimeter. Br J Nutr. 1959;13:501–508. doi: 10.1079/bjn19590064. [DOI] [PubMed] [Google Scholar]
- MacMahon R. A. The use of the World Health Organization's oral rehydration solution in patients on home parenteral nutrition. JPEN J Parenter Enteral Nutr. 1984 Nov-Dec;8(6):720–721. doi: 10.1177/0148607184008006720. [DOI] [PubMed] [Google Scholar]
- Newton C. R., Gonvers J. J., McIntyre P. B., Preston D. M., Lennard-Jones J. E. Effect of different drinks on fluid and electrolyte losses from a jejunostomy. J R Soc Med. 1985 Jan;78(1):27–34. doi: 10.1177/014107688507800106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nightingale J. M., Bartram C. I., Lennard-Jones J. E. Length of residual small bowel after partial resection: correlation between radiographic and surgical measurements. Gastrointest Radiol. 1991 Fall;16(4):305–306. doi: 10.1007/BF01887374. [DOI] [PubMed] [Google Scholar]
- Nightingale J. M., Lennard-Jones J. E., Walker E. R., Farthing M. J. Jejunal efflux in short bowel syndrome. Lancet. 1990 Sep 29;336(8718):765–768. doi: 10.1016/0140-6736(90)93238-k. [DOI] [PubMed] [Google Scholar]
- Saunders D. R., Sillery J. K. Absorption of carbohydrate-electrolyte solutions in rat duodenojejunum. Implications for the composition of oral electrolyte solutions in man. Dig Dis Sci. 1985 Feb;30(2):154–160. doi: 10.1007/BF01308203. [DOI] [PubMed] [Google Scholar]
- Sladen G. E., Dawson A. M. Interrelationships between the absorptions of glucose, sodium and water by the normal human jejunum. Clin Sci. 1969 Feb;36(1):119–132. [PubMed] [Google Scholar]
- Spiller R. C., Jones B. J., Silk D. B. Jejunal water and electrolyte absorption from two proprietary enteral feeds in man: importance of sodium content. Gut. 1987 Jun;28(6):681–687. doi: 10.1136/gut.28.6.681. [DOI] [PMC free article] [PubMed] [Google Scholar]