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Hi everyone!!

Hope you are all keeping well....  

There are numerous posts on electrolytes and I have read I think most of them. There are two questions I need help for which I havent found an answer. So if anyone has knowledge/experience with this I d appreciate your advise:


1) Homemade electrolytes: replacing sodium chloride with sodium bicarbonate?

I ve d tried the St Marks solution and it feels heavy on my stomach. I believe it must be sodium chloride (ie. salt). Do you know if I can replace the sodium chloride amount with sodium bicarbonate (Which is already an ingredient in the recipe in a smaller amount than sodium chloride). i.e. are they equivalent in providing the required sodium and is it safe to take more sodium bicarbonate?

This is the St Mars solution: Ingredients for 1 litre batch:
Glucose powder 20g; 6 teaspoons

Table salt (sodium chloride) 3.5g; 1 level 5mL teaspoon

Sodium bicarbonate or sodium citrate 2.5g; Heaped 2.5mL teaspoon


2) Have you ever been given advise on how much electrolyte replacement you might need per day given the stool output (frequency and stool type) of your j-pouch? Further to the basic advise of "drink when you are thirsty" 

My blood tests for sodium and potassium are normal, while urine sodium and potassium are high, so I am wondering if I am taking too much electrolytes that is later excreted from urine?  In which case I can reduce them without worrying for dehydration.

I also have high renin and aldosteron which theoretically are related to electrolyte balance. My endo says that there is no reason of worry for these. And as blood sodium and potassium are good, then I am fine.

I should say that I have a j-pouch for 12 years. Stool output is usually 5-6 times a day. And I also have secondary adrenal insufficiency.


thank you!!

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Most J-pouchers do not need to fuss with their electrolyte intake. If you have reasonable frequency and your stool isn’t watery then you aren’t flushing excessive electrolytes out. If electrolyte replacement is needed, most people will do better with the St. Marks Solution as specified, rather than replacing the sodium chloride with sodium bicarbonate. Increasing the sodium bicarbonate will make the solution more alkaline, which would likely affect its behavior. It probably hasn’t been studied, so no one can tell you authoritatively how it will behave, except that it will start to act more like a simple bicarbonate solution.

Adrenal insufficiency is beyond the expertise of most of the advice you can get here, so I’d urge caution. If you don’t trust your endocrinologist it might be best to look for a new one. If you are struggling with dehydration then a trusted endocrinologist would be the best person for a discussion on how to proceed.

Hi Scott

thanks for the quick reply.

1)Well I think j-pouch rehydration can be more targeted depending on your output, cause The St Marks document says:

"if your output is high and you are loosing more than 1500ml per day from your stoma, you are at a greater risk of becoming dehydrated.
To prevent dehydration you may be advised to drink 1 to 3 litres of ORS solution, sipped throughout the day.
You should drink _________L of St. 􀀰􀁄􀁕􀁎􀂶􀁖􀀃solution per day.

Obviously this refers to people with an ileostomy, where measuring stool output is easier, nevertheless this shows there can be specific guideline on hydration replacement depending on stool output, but I havent found anything online in regards to j-pouchers . And this is what got me into posting the question.

Its better to have a good idea what you need so that you dont have dehydration episodes or end up having too much of electrolytes, which might be my case. 

2)Yea, well it is not that I dont "trust" my endo, I only discussed this briefly with him and as other j-pouchers also have secondary AI, looking at people s similar experiences I consider it worthwhile. I will discuss it with my endo in more detail for sure.

thanks again for taking the time to discuss this.


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