Most J-pouchers do not need to fuss with their electrolyte intake. If you have reasonable frequency and your stool isn’t watery then you aren’t flushing excessive electrolytes out. If electrolyte replacement is needed, most people will do better with the St. Marks Solution as specified, rather than replacing the sodium chloride with sodium bicarbonate. Increasing the sodium bicarbonate will make the solution more alkaline, which would likely affect its behavior. It probably hasn’t been studied, so no one can tell you authoritatively how it will behave, except that it will start to act more like a simple bicarbonate solution.

Adrenal insufficiency is beyond the expertise of most of the advice you can get here, so I’d urge caution. If you don’t trust your endocrinologist it might be best to look for a new one. If you are struggling with dehydration then a trusted endocrinologist would be the best person for a discussion on how to proceed.

Hi Scott

thanks for the quick reply.

1)Well I think j-pouch rehydration can be more targeted depending on your output, cause The St Marks document says:

"if your output is high and you are loosing more than 1500ml per day from your stoma, you are at a greater risk of becoming dehydrated.
To prevent dehydration you may be advised to drink 1 to 3 litres of ORS solution, sipped throughout the day.
You should drink _________L of St. 􀀰􀁄􀁕􀁎􀂶􀁖􀀃solution per day.
""

Obviously this refers to people with an ileostomy, where measuring stool output is easier, nevertheless this shows there can be specific guideline on hydration replacement depending on stool output, but I havent found anything online in regards to j-pouchers . And this is what got me into posting the question.

Its better to have a good idea what you need so that you dont have dehydration episodes or end up having too much of electrolytes, which might be my case. 

2)Yea, well it is not that I dont "trust" my endo, I only discussed this briefly with him and as other j-pouchers also have secondary AI, looking at people s similar experiences I consider it worthwhile. I will discuss it with my endo in more detail for sure.

thanks again for taking the time to discuss this.

cheers

I have been on Effer-K 20mEq Tablets for years because I am always low on Electrolytes for years  It dissolves in water and I am on 2 a day.  Each tablets provides 20mEq (782mg) of Elemental Potassium in Solution as Potassium Citrate.

how do you know if you are low on electrolytes?  I know when I feel fatigued I drink water.  Is there something else I should be taking?  besides VSL#3ds  I sometimes have watery stools.  

A blood test will show this.  You can ask your primary care doctor.

Thanks Rocco, I will