Secretion

The gastrointestinal tract with its associated glands normally secretes 6 to 9 liters of fluid every 24 h. Most of this volume is secreted by or delivered to the small intestine (e.g. by the pancreatic juice and with the bile), and most of it is reabsorbed there. In a healthy individual, slightly less than 1 l/day passes from the distal ileum into the colon and less than 0.5 liters leaves the body as stool. Increased secretion (as in cholera) and/or decreased fluid absorption in the small intestine (as in mechanical ileus) may rapidly cause significant fluid shifts. This may not necessarily be detected as increased losses or diarrhea since significant amounts could also be lost as stagnant fluid in the distended gut. Such a situation is always present to some extent during obstruction of the distal small intestine and/or colon.

The secreted fluid is not just important in terms of volume. The content of electrolytes or protein in specific regions, including gastric juice, bile, and the highly protein-rich pancreatic juice, warrants special mention.

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