The Interrelations of Faecal Ammonia, pH and Bicarbonate: Evidence of Colonic Absorption of Ammonia by Non-Ionic Diffusion

Abstract

1. Ammonia, bicarbonate and pH were measured in samples of faecal dialysate from thirteen healthy subjects taking free diets. To observe the effect of marked changes in faecal pH, three subjects were also studied while taking 25 mmol/day of MgCO3 or Na2SO4 by mouth. Both salts increased stool weight without causing diarrhoea, but stool pH was significantly increased by MgCO3 and decreased by Na2SO4. 2. The total ammonia concentration and pH of faecal dialysate were very variable, but showed a highly significant negative correlation similar to that already established in man between urinary excretion of ammonia and urine pH. This relationship was more marked when individual subjects were studied while faecal pH was deliberately varied by administration of MgCO3 and Na2SO4. 3. Faecal bicarbonate concentrations were positively correlated with pH. Faecal Pco2 was usually in the range 40–120 mmHg, the higher Pco2 values being found in the more acid samples. Faecal total ammonia concentrations were negatively correlated with faecal bicarbonate. 4. These findings suggest that passive non-ionic diffusion is the main mechanism by which ammonia is absorbed by the colon, but do not exclude a minor contribution from diffusion of ionized ammonium. Colonic secretion of bicarbonate facilitates non-ionic diffusion of ammonia by providing an anion which is also absorbed by non-ionic diffusion, so maintaining an alkaline intraluminal reaction that continues to generate unionized ammonia.