Chronic diarrhea results in the following acid base imbalance
(A) Normal anion gap metabolic acidosis # Causes of Non-Anion-Gap Acidosis# Gastrointestinal bicarbonate loss> Diarrhea> External pancreatic or small-bowel drainage> Ureterosigmoidostomy, jejunal loop, ileal loop> Drugs1 Calcium chloride (acidifying agent)2. Magnesium sulfate (diarrhea)3. Cholestyramine (bile acid diarrhea)> Hypokalemia1. Proximal RTA (type 2)2. Distal (classic) RTA (type 1)> Hyperkalemia# Generalized distal nephron dysfunction (type 4 RTA)> Mineralocorticoid deficiency> Mineralocorticoid resistance> Na+ delivery to distal nephron> Tubulointerstitial disease> Ammonium excretion defect# Drug-induced hyperkalemia (with renal insufficiency)> Potassium-sparing diuretics (amiloride, triamterene, spironolactone)> Trimethoprim> Pentamidine> Angiotensin-converting enzyme inhibitors and AT-II receptor blockers> Nonsteroidal anti- inflammatory drugs> Cyclosporine# Other> Acid loads (ammonium chloride, hyperalimentation)> Loss of potential bicarbonate: ketosis with ketone excretion> Expansion acidosis (rapid saline administration)> Cation exchange resins
Normal anion gap metabolic acidosis
Metabolic alkalosis
Increased anion gap metabolic acidosis
Respiratory acidosis
Miscellaneous