The effect of changes in dietary sodium content on complaints and clinical parameters of volume depletion in patients with a permanent ileostomy.

In seven patients with an ileostomy the volume and electrolyte composition of ileal effluent and urine were studied at the end of 7-day periods on a free diet (mean total sodium excretion 180 mmol/day) and on diets with a fixed sodium content ranging from 120 to 350 mmol/day. At the same time, complaints were scored and the plasma aldosterone concentration, renal aldosterone excretion, and ileal transmucosal potential difference were determined. On a free diet, all of the patients had one or more complaints. These tended to disappear when intake was increased. Changes in dietary sodium led to only minor changes in the volume and composition of the ileal effluent. Significant associations were found between sodium intake and complaints, the urinary sodium/potassium ratio, plasma aldosterone concentration, and aldosterone excretion. The ileal transmucosal potential difference showed the same tendency. Mean sodium intake on a free diet appeared to be suboptimal. The well-being of many ileostomists can be improved by increasing the dietary sodium intake to a level higher than 250 mmol/day.