Can sodium be lost through emesis (vomiting)?

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From the Guidelines

Yes, sodium can be lost through emesis (vomiting).

Mechanism of Sodium Loss

  • Vomiting can lead to excessive loss of sodium, particularly in patients with certain medical conditions, such as cystic fibrosis 1 or those undergoing upper gastrointestinal and pancreatic procedures 1.
  • The loss of sodium through vomiting can result in inadequate levels of sodium in the body, potentially leading to impaired growth, particularly in infants 1.
  • Sodium deficiency can also occur due to the low sodium content of breast milk and standard infant formula, making it essential to monitor sodium levels in these patients 1.

Clinical Implications

  • In patients with vomiting, it is crucial to assess and replace sodium losses to maintain fluid and electrolyte balance 1.
  • The use of oral rehydration solutions (ORS) with a sodium concentration of 90 mmol/l or more can help replace sodium losses and maintain sodium balance 1.
  • In some cases, adding extra salt or using sodium supplements may be necessary to maintain sodium balance, particularly in patients with high stomal losses 1.

Management

  • Patients with vomiting should be encouraged to drink ORS solutions in small quantities throughout the day to replace sodium losses and maintain hydration 1.
  • It is essential to monitor sodium levels and adjust replacement therapy as needed to prevent sodium deficiency and related complications 1.

From the Research

Sodium Loss through Emesis

  • Sodium can be lost through emesis (vomiting) as stated in the study 2, which mentions that hyponatremia due to sodium deficiency is caused by sodium loss from kidney and/or extrarenal sources such as vomiting and diarrhea.
  • Another study 3 also supports this, stating that extrarenal sodium loss due to vomiting or diarrhea is one of the most frequent causes of hyponatremia.
  • Additionally, a study on hyponatremia in cancer patients 4 mentions that gastrointestinal losses of sodium, including vomiting, can lead to sodium depletion.
  • However, a study on hypernatremia 5 does not directly address sodium loss through emesis, but rather focuses on water loss and salt gain as causes of hypernatremia.
  • A study on the use of buffered sodium supplements during an ultramarathon 6 examines the relationship between sodium intake and nausea or vomiting, but does not specifically address sodium loss through emesis.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

[Hyponatremic syndrome].

La Clinica terapeutica, 2012

Research

[Hyponatremia in cancer patients].

Nihon Jinzo Gakkai shi, 2012

Research

A Quick Reference on Hypernatremia.

The Veterinary clinics of North America. Small animal practice, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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