Hyponatremia in the context of gastrointestinal diseases

Authors: L. Vítová
Authors‘ workplace: Interní klinika LF UK a FN Motol, Praha
Published in: Gastroent Hepatol 2018; 72(4): 345-350
doi: 10.14735/amgh2018345


Diseases of the gastrointestinal tract (GIT) often lead to changes in the homeostasis of serum electrolyte concentrations and of acid-base and water balance. There is a large turn in water and electrolytes throughout the digestive tract. GIT is involved in electrolyte balance, water absorption, and excretion. GIT mucosa secretes a large amount of juices. Pathological conditions (increased secretion or decreased reabsorption) contribute to the deregulation of homeostasis of the internal environment. These disorders can vary in intensity from accidentally detected laboratory abnormalities to life-threatening conditions. The following review article addresses hyponatremia – the most common disorder of the internal environment – in the context of GIT diseases. The various clinical situations that may be associated with hyponatremia are discussed. In addition, hyponatremia is often accompanied by a number of other abnormalities of the internal environment, these must be respected during the treatment. It is necessary to obtain a range of data – both anamnestic and laboratory data – including changes in these data during the course of treatment. Equally important is the careful execution of a basic physical examination focusing on hydration. Understanding the pathophysiological mechanisms that lead to hyponatremia, along with detailed clinical-laboratory image analysis, is the only way to obtain an accurate differential diagnosis of hyponatremia. For physicians across all areas of expertise, it is important to perform recommended laboratory tests prior to therapy initiation, afterwards these data enable us the correct interpretation of the  abnormalities.

Key words:

gastrointestinal diseases – disorders of homeostasis – hyponatremia

The author declares he has no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted: 28. 6. 2018

Accepted: 3. 8. 2018 


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