An Ileal Bypass Patient With Watery Diarrhea

Robert M. Centor, MD


November 01, 2006

Case Presentation

A 50-year-old woman presents with watery diarrhea. She gives a history of ileal bypass for morbid obesity. She has been having 10-15 watery stools each day. The intern gave her narcotics to decrease the diarrhea. The next morning he finds her somnolent.

Laboratory Analyses

Electrolyte panel: Sodium 130 mEq/L; potassium 3.2 mEq/L; chloride 102 mEq/L; bicarbonate 10 mEq/L; blood urea nitrogen (BUN) 13; creatinine 1.2 mg/dL; glucose 96 mg/dL

Arterial blood gas: pH 7.02; pCO2 40; pO2 180; calculated bicarbonate 11

The Problem

What is her acid-base disorder?

Speculate on the sequence of events that could explain these values.


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