info

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Overview

Electrolytes are salts that conduct electricity and are found in the

body fluid, tissue, and blood. Examples are chloride, calcium,

magnesium, sodium, and potassium. Sodium (Na+) is concentrated in the

extracellular fluid (ECF) and potassium (K+) is concentrated in the

intracellular fluid (ICF). Proper balance is essential for muscle

coordination, heart function, fluid absorption and excretion, nerve

function, and concentration.

The kidneys regulate fluid absorption and excretion and maintain a

narrow range of electrolyte fluctuation. Normally, sodium and

potassium are filtered and excreted in the urine and feces according

to the body's needs. Too much or too little sodium or potassium,

caused by poor diet, dehydration, medication, and disease, results in

an imbalance. Too much sodium is called hypernatremia; too little is

called hyponatremia. Too much potassium is called hyperkalemia; too

little is called hypokalemia.

Incidence and Prevalence

Hyponatremia is the most common electrolyte imbalance. It is

associated with kidney disease such as nephrotic syndrome and acute

renal failure (ARF). Men and women with healthy kidneys have equal

chances of experiencing electrolyte imbalance, and people with eating

disorders such as anorexia and bulimia, which most often affect

women, are at increased risk. Very young people and old people are

affected more often than young adults.

Hyponatremia

Causes

Hyponatremia is caused by conditions such as water retention and

renal failure that result in a low sodium level in the blood.

Pseudohyponatremia occurs when too much water is drawn into the

blood; it is commonly seen in people with hypoglycemia (low blood

sugar).

Psychogenic polydipsia occurs in people who compulsively drink more

than four gallons of water a day.

Hypovolemic hyponatremia (with low blood volume due to fluid loss)

occurs in dehydrated people who rehydrate (drink a lot of water) too

quickly, in patients taking thiazide diuretics, and after severe

vomiting or diarrhea.

Hypervolemic hyponatremia (high blood volume due to fluid retention)

occurs in people with live cirrhosis, heart disease, or nephrotic

syndrome. Edema (swelling) often develops with fluid retention.

Euvolemic hyponatremia (decrease in total body water) occurs in

people with hypothyroidism, adrenal gland disorder, and disorders

that increase the release of the antidiuretic hormone (ADH), such as

tuberculosis, pneumonia, and brain trauma.

Signs and Symptoms

Symptoms of hyponatremia are related to the severity and the rate at

which the conditions develop. The first symptoms are fatigue,

weakness, nausea, and headache. More severe cases cause confusion,

seizure, coma, and death.

Treatment

The goal of treatment is to restore electrolyte balance for proper

hydration and use of total body fluid. Sodium deficiency must be

corrected slowly because drastic change in sodium level can cause

brain cell shrinkage and central pontine myelinolysis (damage to the

pons region of the brain). Methods include:

Fluid and water restriction

Intravenous (IV) saline solution of 3% sodium

Salt tablets

[Guest guest]

>

> Overview

>

> Electrolytes are salts that conduct electricity and are found in

Some 'great' info there Tina. Thanks for sharing.

Donna DM

[Guest guest]

superb information thank you

tina83862 <tina83862@...> wrote: WHAT ARE GALLSTONES AND GALLBLADDER

DISEASE?

Bile and the Gallbladder

The formation of gallstones is a complex procedure that starts with

bile, a fluid composed mostly of water, bile salts, lecithin (a fat

known as a phopholipid), and cholesterol. (Most gallstones are

formed from cholesterol.)

Bile is first produced by the liver and then secreted through tiny

channels that eventually lead into a larger tube called the common

bile duct , which leads to the small intestine.

Only a small amount of bile drains directly into the small

intestine, however. Most flows into the gallbladder through the

cystic duct , which is a side extension off the common duct. (The

system of ducts through which bile flows, including the common bile

duct is called the biliary tree).

The gallbladder is a four-inch sac with a muscular wall that is

located under the liver. Here, most of the fluid (about two to five

cups a day) is removed, leaving a few tablespoons of concentrated

bile.

Bile is important for the digestion of fat. The gallbladder serves

as a reservoir until bile is needed in the small intestine for this

function.

A hormone called cholecystokinin is released when food enters the

small intestine. Cholecystokinin signals the gallbladder to contract

and deliver bile into the intestine.

The force of the contraction propels the bile back down the common

bile duct and then into the small intestine, where it emulsifies

(breaks down) fatty molecules.

This process allows the emulsified fat as well as fat-absorbable

nutrients, including vitamins A, D, E, and K, to enter the blood

stream through the intestinal lining.

Formation of Gallstones (Cholelithiasis)

About three-quarters of the gallstones found in the US population

are formed from cholesterol. About 15% of gallstones are known as

pigment stones. Patients may also have a mixture of pigment and

cholesterol gallstones. Gallstones can range from a few millimeters

to several centimeters in diameter.

Cholesterol Stones. Cholesterol makes up only five percent of bile.

It is not very soluble, however, so in order to remain suspended in

fluid, it must be properly balanced with bile salts. If there is an

imbalance in bile salts and cholesterol, the following occurs:

The fluid turns to sludge, which consists of a mucus gel containing

cholesterol and calcium bilirubinate.

If the process continues, cholesterol crystals form out of the bile

solution ( supersaturation) and can eventually form gallstones.

This process is referred to as cholelithiasis. It is very slow and

most often painless.

Supersaturation and cholelithiasis can occur as a result of various

abnormalities, although the cause is not entirely clear. Events that

may promote cholelithiasis include the following:

The liver secretes too much cholesterol into the bile.

The gallbladder has defective emptying mechanisms so that the bile

becomes stagnant and sludge forms, eventually forming stones.

The cells lining the gallbladder may lose their capacity to

efficiently absorb cholesterol and fat from bile.

Pigment Stones. Pigment stones are composed of calcium bilirubinate,

or calcified bilirubin. Bilirubin is a substance normally formed by

the breakdown of hemoglobin in the blood and it is excreted in bile.

Pigment stones can be black or brown and often form in the

gallbladders of people with hemolytic anemia (a relatively rare

anemia where red blood cells are destroyed) or cirrhosis.

Effects of Gallstones. Gallstones can cause obstruction at any point

along the ducts that carry bile:

In most cases of obstruction, the stones block the cystic duct,

which leads from the gallbladder to the common bile duct. This can

cause pain ( biliary colic ), infection and inflammation (called

cholecystitis), or both.

About 10% of patients with symptomatic gallstones also have stones

that pass into and obstruct the common bile duct (called

choledocholithiasis).

Gallbladder Diseases without Stones

Gallbladder disease can occur without stones (called acalculous

gallbladder disease). [ See Box Gallbladder Disease without Stones.]

GALLBLADDER DISEASE WITHOUT STONES

(A CALCULOUS GALLBLADDER DISEASE)

Gallbladder disease can occur without stones (called acalculous

gallbladder disease). It can be acute or chronic.

Acute acalculous gallbladder disease usually occurs in patients who

are very ill from other disorders. In such cases, inflammation

occurs in the gallbladder, usually from a diminished blood supply or

an impairment in the ability of the gallbladder to contract.

Chronic acalculous gallbladder disease (also called biliary

dyskinesia) appears to be caused by defects in the gallbladder that

impair its ability to contract and release bile.

Diagnosing Chronic Acalculous Gallbladder Disease

Chronic acalculous gallbladder disease is usually diagnosed when a

patient complains of gallbladder symptoms but there is no radiologic

evidence of stones. (More than half of patients initially diagnosed

with this disease however, are eventually shown to have small stones

or gallbladder sludge.) The patient is given the hormone

cholecystokinin octapeptide (CCK), which induces gallbladder

contraction, followed by a radioisotope scan that determines if the

gallbladder is emptying correctly. If the gallbladder demonstrates

difficulty releasing bile, doctors usually consider the diagnosis

confirmed.

Treatment for Chronic Acalculous Gallbladder Disease

Most patients (75% to 90%) diagnosed with chronic acalculous

gallbladder disease [ see above ] are relieved of their symptoms by

cholecystectomy (removal of the gallbladder). [ See What Are the

Surgical Procedures for Gallstones and Gallbladder Disease?, below.]

More than half of patients are subsequently shown to have small

stones or gallbladder sludge that was not visible on their

ultrasounds. A 2001 study indicates that a muscle defect might be

the cause of the disease in patients who do not have stones or

sludge.

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