Effect of 9-α-Fluorohydrocortisone on the Ileal Excreta of Ileostomized Subjects

Sodium deprivation, produced by sodium restriction or loss, results in a fall in the sodium and a rise in the potassium content of ileal excreta of ileostomized subjects. An endogenous aldosterone secretion has been postulated. To determine whether similar changes could be induced by exogenous mineralocorticoids, 9-α-fluorohydrocortisone, 2 mg per day by mouth, was administered to 5 subjects with stable ileostomy function who had had total colectomies for ulcerative colitis. Balance techniques were used. Contrary to the response seen with sodium deprivation, the 24-hr excretion of sodium was unaffected but mean potassium excretion and concentration in the ileal excreta increased ( P P = 0.03) but not in the mean potassium output occurred indicating that the renal and small intestinal responses to exogenous oral 9-α-fluorohydrocortisone differed in our subjects. In 1 additional subject who was probably sodium-depleted, a decrease in the mean ileal sodium excretion (milliequivalents per day) occurred while the sodium concentration rose during 9-α-fluorohydrocortisone administration. The mean urine sodium excretion showed a further fall from control levels in this patient while the mean potassium excretion rose. It is, therefore, possible that exogenous mineralocorticoids in sodium-deprived individuals with ileostomies may be of therapeutic value by aiding them to conserve salt.