Severe diarrhea is associated with chloride levels that are:

• A. High
• B. Low
• C. Normal
• D. Variable

Answer: (A)

When severe diarrhea occurs, a lot of bicarbonate is lost in the stool. This creates a metabolic acidosis with a normal or near-normal anion gap. To balance the negative charges in the body, chloride ions rise to compensate for the bicarbonate loss, leading to higher serum chloride—hyperchloremia. So, the most consistent finding is elevated chloride levels. Low, normal, or highly variable chloride would not reflect this bicarbonate-loss pattern typical of severe diarrhea.