Mnemonic

Intestinal Fluid Balance

A memory aid for the daily fluid load handled by the gut.

Expansion

About 9 litres enters the gut daily and only 100 ml is lost in stool

Expansion

Daily inputs to the gut lumen:

Source Volume
Diet 2000 ml
Saliva 1500 ml
Gastric juice 2000 ml
Bile 500 ml
Pancreatic juice 1500 ml
Intestinal secretions 1500 ml
Total about 9 litres

Absorption:

  • Small intestine: about 7.5 litres
  • Colon: about 1.4 litres, with a reserve capacity up to about 5 litres
  • Stool: about 100 ml

The key insight is that most of the fluid is endogenous. A high-output fistula, prolonged vomiting, ileus with sequestration, or a secretory diarrhoea therefore deplete the extracellular compartment far faster than reduced intake alone ever could.

Electrolyte content differs by site, which guides replacement: gastric losses are rich in hydrogen, chloride and potassium (causing hypochloraemic alkalosis), while small bowel, biliary and pancreatic losses are rich in sodium and bicarbonate (causing acidosis).