<![CDATA[Ileostomy reduces colonic fluid and electrolyte reabsorption and could increase the risk of early postoperative dehydration and electrolyte disturbances. This study described early changes in serum sodium, potassium, and chloride levels after ileostomy in patients with colorectal cancer and their implications for hydration and nutritional care. This retrospective longitudinal study reviewed medical records at H. Adam Malik General Hospital, Medan, Indonesia, during 2025; data were extracted from April to June 2026. Of 263 patients with ileostomy identified, 75 patients with colorectal cancer who met the eligibility criteria and had complete electrolyte measurements preoperatively and on postoperative days 1 and 3 were analyzed. Global temporal differences were assessed using the Wilcoxon test at α = 0.05. Results, mean sodium decreased from 141.6 ± 5.7 mmol/L preoperatively to 137.9 ± 6.9 mmol/L on day 3, while chloride decreased from 104.7 ± 3.5 to 101.0 ± 9.3 mmol/L; both showed significant temporal differences (p < 0.001). Potassium showed no significant difference (p = 0.573). On day 3, normal sodium, potassium, and chloride values were observed in 56%, 60%, and 68% of patients, respectively. In conclusion, early post-ileostomy electrolyte changes were most apparent for sodium and chloride. These findings support serial electrolyte and hydration monitoring and integration of hydration assessment with nutritional care.]]>
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