D in MC is caused by inability to absorb sodium??

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Zizzle
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D in MC is caused by inability to absorb sodium??

Post by Zizzle »

I was checking out the latest medical literature on MC in eMedicine/Medscape, and was surprised to learn that the actual cause of the watery D is thought to be lack of sodium absorption in the colon, leading to water secretion into the colon! This is new to me!!

As someone with very low blood pressure, I eat a relatively high sodium diet and still seem to have a hard time staying hydrated. Could excess salt in my diet be making my MC worse? How else can I get my BP up if my body won't absorb the salt I'm eating???
"Precise mechanism of diarrhea in patients with microscopic colitis still remains unclear. Most of the authors believe that dominant processes in the development of diarrhea are: 1. Reduced active sodium absorption 2. Inhibited chloride and bicarbonate exchange 3. Increased electrogenic chloride secretion followed by passive sodium and water transport. 4. Decreased passive permeability of colonic mucosa."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320367/
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tex
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Post by tex »

Hi Zizzle,

Good to see a post by you again. Hope you're doing well. Actually, secretory diarrhea (the hallmark of MC) is caused by the infusion of all of the electrolytes (and water) into the colon, not just sodium. I doubt that sodium intake particularly matters (any more than intake of the other electrolytes). When I was initially reacting, I had to go to the ER a couple of times, as I recall, and I believe I was low on potassium both times (I was given a prescription for a potassium supplement). I don't recall that any other electrolyte was low (at least none were ever mentioned).

As far as I'm aware, salt is very dehydrating (I used to use it to dry hides, as an amateur taxidermist), so it should cause constipation, rather than diarrhea. I'm not aware of any reason why salt would provoke an MC reaction, but I doubt that this has ever been medically researched.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by Zizzle »

Hi Tex!
I'm doing pretty well, still in my THC clinical trial (2 years), which really helps the MC and food reactions.
I get bloodwork every 2 months for the clinical trial, and it's always normal (except for low lymphocytes and signs of hypoglycemia). I can be near passing out with 85/54 blood pressure when the sample is taken, and electrolytes are still normal. :shrug:

Why would sodium INTAKE not matter, if they are saying the colon is failing to absorb the sodium and other electrolytes in the fecal stream? Where else would they come from?

Where does sodium first start being absorbed by the body after intake? I thought the stomach or small intestine. Why would it still reach the colon unless it's excess intake the body didn't want to absorb earlier? Or does the body absorb it early and dump the excess into the colon? I need an anatomy lesson!
1987 Mononucleosis (EBV)
2004 Hypomyopathic Dermatomyositis
2009 Lymphocytic Colitis
2010 GF/DF/SF Diet
2014 Low Dose Naltrexone
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tex
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Post by tex »

When I say that sodium intake doesn't matter, I mean it shouldn't matter more than the intake of any other electrolyte. Blood levels of all electrolytes must be maintained within a relatively narrow normal range, in order to keep all the vital organs functioning normally. All electrolyte reserves are stored in the cells, and then they when they're needed to keep the blood level within the normal range, they're pulled back out of the cells.

Electrolytes are normally absorbed all along the intestinal track (both the small intestine and the colon). Nutrient and electrolyte extraction/absorption is not a perfect process, and it's rarely complete. MC exacerbates that problem and really disrupts normal absorption. Electrolytes and vitamins, (and water) are the only nutrients absorbed by the colon, (presumably to make sure that only minimal amounts of precious electrolytes are wasted). After meals, the blood levels (of electrolytes) go up, and between meals they go down. When the blood levels are higher than normal, the excess is transported to the cells for storage. When the blood levels are below normal, electrolytes are extracted from the cells and returned to the blood in order to maintain normal blood levels. If the blood levels of electrolytes fall below the normal range, things begin to go wrong, and severely low levels can be fatal. The same consequences can happen if blood levels get too high.

As far as I'm aware, secretory diarrhea is unique (among the types of diarrhea) in causing the colon to infuse electrolytes and water (and presumably vitamins) into the lumen. Normally, diarrhea does not cause that. It happens only if secretory diarrhea is active. That's why it can cause dehydration problems so fast.

I hope that helps.

Tex
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It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Post by dolson »

When I was walking 9 to 10 times daily, I was losing sodium. I was losing sodium through sweat and we do lose sodium here in sultry hot Georgia. I remember Salt Lick in Buda and Austin, TX. That's where the cows, horses and other animals lick the salt because of the extreme heat. Watch out for your sodium level. Dorothy
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Post by Erica P-G »

I've been on a healing streak for 4 years now....and just this July I had my hair analysis and I was quite low in Sodium, Potassium, Molybdenum, Manganese and I was told to get a good grade of sodium and add it (sea salt or himalayan type) to my water along with some magnesium, plus a good basic B's and was advised to get Thornes.

After doing this combo I am doing so much better :-) My stools are much happier, am I perfect every day...no...but I'm feeling so much better.

Also this combo reflects adrenal fatigue....and that takes a while to help reverse....so anyone reading this and can't get past the tired sluggishness this may be an area for you to research ;-)
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Dx LC April 2012 had symptoms since Aug 2007
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