What is the most common electrolyte disturbance associated with enteric fistulas?

The most common electrolyte disturbance in patients with intestinal fistulas is hypokalemia. After the occurrence of an intestinal fistula, leakage of intestinal contents leads to significant loss of digestive fluids and electrolytes, with particularly pronounced loss of potassium ions. The normal range for serum potassium levels is 3.5–5.3 mmol/L; due to severe fluid and electrolyte losses, patients with intestinal fistulas often develop decreased blood potassium levels. Hypokalemia may cause symptoms such as limb weakness, progressive limb flaccidity, and even paralysis; in severe cases, it can even be life-threatening. Therefore, timely monitoring of serum potassium levels and appropriate fluid replacement therapy are crucial for patients with intestinal fistulas. In addition, patients with intestinal fistulas may also develop other types of electrolyte disturbances such as hyponatremia, hypernatremia, and hyperkalemia, as well as pathophysiological changes including dehydration and acid-base imbalance. The occurrence of these complications is closely related to the severity of the fistula and whether treatment is timely. Therefore, a comprehensive assessment should be conducted on each patient to develop an individualized treatment plan aimed at minimizing complications and improving patient outcomes.