Absorption and Ileal Conduit

Posted by Pam on May 27, 1999 at 20:50:56
I have been living with an ileal conduit for 25 years and started reading lately about people with such surgeries perhaps absorbing certain nutrients or medications differently.  This issue has never been raised by any of my physicians and I'm wondering if this is something I should be learning more about.  Is there a certain specialty that might help me understand the issue more clearly?  Any guidance you can provide me regarding prevention of long-term health problems and resources to learn more about this issue would be appreciated.

Posted by HFHS M.D.-AK on May 30, 1999 at 21:26:47
Dear Pam,
Overall complication rates for enteric urinary conduits are 50-80% over the life of the conduit.  Fortunately, the majority of complications are not severe.  The problems include renal deterioration, metabolic abnormalities, hydronephrosis, loop stenosis, ureteral strictures, stomal problems, calculi, and malignancy.
Your question deals directly with the metabolic abnormalities that can occur after enteric conduits are formed.  Each segment of bowel has its own physiology and absorption tendencies.  An ileal conduit absorbs chloride and ammonium but secretes bicarbonate and hydrogen ions.  Although rarely a clinical problem, these patients may develop hypokalemia (low potassium) associated with hyperchoremic (high chloride) metabolic acidosis.  These problems often occur in patients with renal insufficiency but you should have your electrolytes checked periodically.
If you had a problem, you would be very ill.  However, it is still important to know about the potential problems that face you after having an ileal conduit for so many years.  
I would talk to your doctor and make sure you have routine follow-up with periodic evaluation of your electrolytes.  A nephrologist may have some further information, but unless you have a problem, I would not worry about it.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Ileal Conduit