SODIUM-ION MOVEMENT ACROSS INTESTINAL MUCOSA IN CHOLERA PATIENTS

Whole-bowel perfusion with the addition of isotope labelling has been used to study sodium-ion transport across the intestinal mucosa in human cholera. The site of maximal disturbance of ion transfer was in the duodenum and upper jejunum. During the acute phase of the disease there was a striking reduction in bidirectional sodium movement across the mucosa. The movement from lumen to plasma was the more depressed, and this resulted in net accumulation of sodium in the intestinal lumen. These findings do not support previous concepts of predominant effects of cholera on a sodium pump or excess filtration and secretion, but raise wider issues relating to mucosal-cell function and the splanchnic circulation. These disturbances may not be unique to cholera, and their elucidation may explain the pathogenesis of other diarrhœal states.