Will an Indiana pouch mess up your body chemistry?

Will an Indiana pouch mess up your body chemistry?

            The segment of colon that replaces the bladder works well as a reservoir but it allows chemicals such as hydrogen ion and chloride to get back into the bloodstream. The resultant excess in the blood of hydrogen and chloride ions produces hyperchloremic acidosis in some Indiana pouch recipients. Luckily, most patients will escape this problem but there are factors such as poor kidney function that make it more likely to occur.

            The tendency toward acidity can lead to loss of calcium from the bones, increasing the risk of osteoporosis. It’s not that simple, however, since there are several other factors that contribute to osteoporosis. Bladder cancer is a disease of the older generation, in whom osteoporosis has become increasingly common. The main cause of this condition is lack of exercise, not calcium deficiency. Studies have confirmed that simply adding calcium to the diet will not prevent fractures.

            Some patients with an Indiana pouch develop vitamin B₁₂ deficiency but that is also not necessarily due to the revised anatomy. Vitamin B₁₂ is absorbed from the last portion of the small intestine but only a scant few inches are used to form the Indiana pouch. About 10 percent of seniors develop vitamin B₁₂ deficiency for other reasons.

            A simple blood test can identify hyperchloremic acidosis and treatment consists of taking sodium bicarbonate. This should only be done under the supervision of a physician. Self-medication could cause other problems.

            A special type of x-ray examination can indicate osteoporosis or the stage that precedes it, called osteopenia.

            The blood test for identifying vitamin B₁₂ deficiency is not entirely reliable but all seniors ought to be on a daily multivitamin anyway and should be checked periodically for anemia due to other causes.