Maintaining Electrolyte Balance in IBD Patients: A Nutritionist’s View

Maintaining Electrolyte Balance in IBD Patients: A Nutritionist’s View
In regards to diet in inflammatory bowel disease (IBD), the focus is often on how to eat to avoid pain, and optimize macronutrient and vitamin intake while limiting physical side effects. This is important, but another important factor to consider in the nutrition matrix in IBD is fluid and the issue of fluid balance.  Individuals with IBD run the risk of developing electrolyte imbalances secondary to the fluid changes that occur during flare-ups, especially from diarrhea as well as malabsorption deficiencies. Symptoms of electrolyte imbalances include muscle pain and weakness, headaches, confusion, depression, seizures, and irregular heartbeat.  There are certain minerals in the body that must be maintained in appropriate balance, including calcium, chloride, magnesium, phosphate, potassium, and sodium. The harmony of these minerals in the body are what regulates the most important bodily functions, including fluid acid-base balance, cardiac and brain function, and the delivery of oxygen to the cells.  Crohn's disease (CD) and ulcerative colitis (UC) present different electrolyte challenges. UC is confined to the colon, whereas CD is found in the small and large intestines. A number of studies reviewed in a 2013 article suggested that electrolyte deficiencies in UC patients may even be life-threatening, with the main transport abnormality being the decrease in net sodium and chloride absorption, resulting in impaired water absorption and secretion.  This review also reported a study that found that, of 63 patients with CD who were assessed for electrolyte disorders, 33% had low levels of sodium, potassium, calcium, and magnesium in their blood, either alone or in combination. In addition, hypocalcemia, or low calcium, may be observed, due to both limite
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