Net and unidirectional transmucosal flux of sodium and water in acute human diarrheal disease

Nine Indian patients with bacteriologically-proven cholera diarrhea, 3 with diarrhea attributable to an enteropathogenic strain of Escherichia coli, and 6 Indian male control subjects were studied by means of the triple lumen tube perfusion technique. Net (J_net) and unidirectional mucosa to serosa (Lm /ar s) and serosa to mucosa (Js → m) l flux rates were measured utilizing ²⁴Na and ³HOH in jejunum and ileum in the acute and convalescent phase of the disease Ali 12 patients with cholera and E. coli diarrhea demonstrated ne⁺ fluid secretion into the bowel lumen (± 3.05 and ± 1.41 ml. per hour per centimeter), while control subjects demonstrated net fluid absorption (± 0.8 ± 0.35 ml. per hour per centimeter). In all acute diarrheal disease both Js → m and Jm → s flux for sodium and water were increased but the greate increase in Js → m primarily accounted for the change from a normal net absorptive state to net secretion of sodium and water into the intestinal lumen. Unidirectional fluxes of ²⁴Na and ⁷HOH were increased 3 to 5 fold over convalescent and control levels. An increase in J_{s → m}^H₂O in the jejunum was correlated with net jejunal fluid secretion (r = 0.75), fasting intestinal (jejunal) flow rates (r = 0.67) and stool output (r = 0.58) in acute cholera diarrhea.