Marathon without a colon: salt and water balance in endurance running ileostomates

Five trained ileostomates completed a marathon in a cool environment without ill effect. During the race, the ileostomy losses of sodium (1.0-2.7 mmol.h-1) and of water (9.2-19 ml.h-1) were small, but urinary excretion of sodium was very low (0.2-0.75 mmol.h-1) despite drinking a combination of water and glucose-electrolyte solution. The concentration of potassium in the ileostomy discharge tended to increase, also suggesting a sodium retaining state. Healthy ileostomates after suitable training are successful marathon runners, but the prevalence of mild salt depletion in ileostomates generally suggests that it may be advisable for them to take only glucose-electrolyte solutions when competing at any ambient temperature or when preparing for a marathon which is to take place in a warm environment.