Which electrolyte abnormalities are associated with chronic diarrhea?

Which electrolyte abnormalities are associated with chronic diarrhea?

• A. Hyponatremia, hypokalemia, metabolic acidosis
• B. Hypernatremia, hyperkalemia, metabolic alkalosis
• C. Normal electrolytes
• D. Hypercalcemia only

Answer: (A)

Chronic diarrhea causes loss of bicarbonate and electrolytes in the stool, along with overall fluid loss. Losing bicarbonate in the intestinal contents produces a non-anion gap (hyperchloremic) metabolic acidosis. At the same time, sodium and water are lost in the stool, which often leads to hyponatremia. Potassium is also secreted into the gut and lost in stool, resulting in hypokalemia. This combination—hyponatremia, hypokalemia, and metabolic acidosis—is characteristic of prolonged diarrheal losses. Patterns like hypernatremia with metabolic alkalosis or isolated hypercalcemia don’t fit this mechanism, and normal electrolytes would miss the ongoing losses seen with chronic diarrhea.

Chronic diarrhea causes loss of bicarbonate and electrolytes in the stool, along with overall fluid loss. Losing bicarbonate in the intestinal contents produces a non-anion gap (hyperchloremic) metabolic acidosis. At the same time, sodium and water are lost in the stool, which often leads to hyponatremia. Potassium is also secreted into the gut and lost in stool, resulting in hypokalemia. This combination—hyponatremia, hypokalemia, and metabolic acidosis—is characteristic of prolonged diarrheal losses. Patterns like hypernatremia with metabolic alkalosis or isolated hypercalcemia don’t fit this mechanism, and normal electrolytes would miss the ongoing losses seen with chronic diarrhea.