Daily Medical Advices

There is an increased secretion of electrolytes (especially sodium and chloride) into the intestinal dragging water, due to an alteration in the transport of water and ions across the epithelium of intestine. In most cases dominated decreased absorption, but sometimes there is an inappropriate increase in the secretion of fluid into the lumen. In this case, we often speak of “watery diarrhea” 9 The first goal of treatment is correction of dehydration, for which fluids are preferably administered orally or intravenously to replace the fluids lost in diarrhea.
In secretory diarrhea, observe the following:

• as diarrhea is caused by a disorder of ion transport, there is no response (or very little) to fasting: no fecal volume decreases or increases if swallowed
• the osmotic gradient between the osmolarity of the stool and plasma is very small;
• fecal sodium usually> 60 mOsm; approximately equal to the plasma;
• sodium loss is greater than that of potassium;
• tend to be bulky stools, more than 1 liter per 24 h.
• fecal pH is usually neutral
• concomitant loss of bicarbonate causes a metabolic acidosis.

However, some secretory diarrhea, such as those due to malabsorption of fatty acids or laxatives such as castor oil and bile acids, can be transferred with fasting.