Ask the Colorectal Surgeon

Dr. Beck is board certified in general and colon and rectal surgery and is a Clinical Professor of Surgery at Vanderbilt. Dr. Beck conducts research into colorectal diseases, has authored and edited nine medical textbooks, and written over 350 scientific publications. He was the President of the American Society of Colon and Rectal Surgeons (ASCRS) from 2010-2011. Dr. Beck is a nationally recognized expert in inflammatory bowel disease, anal, rectal and colon cancer, stomas, adhesions, bowel preparation, sphincter saving surgery for cancer, laparoscopic surgery, and postoperative pain management.

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Low Sodium Levels

I acquired an ileostomy 30 years ago due to ulcerative colitis. I’m now 66 years old and very active outdoors both winter and summer. I have recently been diagnosed with high blood pressure and my physicians have put me on 50mg of hydrochlorothiazide and 25mg of spironolactone which are both diuretics. I have been told to curtail my salt intake even though my labs show low sodium levels. The advice is confusing and has made my restless leg problem worse and I’m concerned about getting dehydrated.
Many internists (the type of physician who usually treats high blood pressure) have little experience with ostomates. Having an ileostomy usually results in an above average loss of sodium and other electrolytes. The combination of a low sodium diet, an ileostomy and two diuretics seems excessive. You did not mention your weight. Being overweight or obese results in high blood pressure. Losing weight may also reduce the need for medication. I would go back to your physician and discuss your concerns. Depending on how high your blood pressure was and is currently, they may be able to reduce or change your medication.
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