FECAL ORGANIC ANION IN INFANTINE DIARRHEA

Abstract

Organic anion (OA⁻) has been identified as the largest component in stools from infants with malabsorptive diarrhea. Tlie presently, available techniques to measure OA⁻ have given unreliable results. The object of this study Was to compare the data from four different methods of OA⁻ measurement to evaluate the losses of OA⁻ in feces from 12 infants 2 to 11 months old during recovery from carbohydrate intolerance. Daily Samples were analysed for osmolality, electrolytes, and total OA⁻ measured by: 1) Titration (T): from pH 2.7 to fecal pH; 2) Gas-chromatography (GC) the sum of short, medium and long chain fatty acids, plus lactate, pyruvate and the Krebs cycle OA⁻; 3) Undertermined anions (UA) : as the sum of (Na+k+Ca+Mg) - (C]+1.8P); and 4) as (Na+K+Cl). Mean total OA⁻ measured as UA was 121 + 58 mEq/kg, not statistically different from both total OA⁻ estimated by GC (107+ 39 mEq/kg) and and/or T (147 + 52mEq/kg). (Na+k-Cl) represented only a small fraction of total OA⁻: 53 ± 30 mEq/kg and osmolality was 366 ± 76 φOsm/kg. A significant correlation was obtained between UA and T, r= .91, p <.001, but less directly related to GC: r= .67, P <.01. Osmolality demonstreted good correlation with UA, T and GC: r= .88, r=.88, r=.87, respectively. We conclude that (Na+k-Cl) underestimates the total CA in stool and UA represents the best approach for the estimation of the fecal OA⁻ component in infantile diarrhea. T is a reliable option for UA, since UA is a time-consuming procedure.

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