St. Mark’s Solution for Adults and Adolescents

What is St. Mark’s Solution?

St. Mark’s Solution is a potassium-free glucose-electrolyte mix Oral Rehydration Solution (ORS). This helps to increase your fluid absorption hopefully, reducing your need for intravenous fluids or nutrition.

It is often used in short bowel syndrome when part of your bowel has been removed by surgery or for conditions that affect absorption from the bowel. If you have a stoma, St. Mark’s Solution may also be recommended by your doctor or dietician.

Why do I need to use St. Mark’s Solution?

If you have one of the above conditions, it can be hard to absorb enough water or electrolytes (for example, sodium and potassium) from your food and drink. This can lead to dehydration, weight loss and changes in your electrolyte levels.

Why not use sports drinks or other rehydration solutions?

Standard ‘sports drinks’ are not suitable. This is because these have high levels of sugar and low levels of sodium. Other oral rehydration solutions often contain potassium which can cause high potassium in your blood which can be dangerous.

St. Mark’s Hospital in London has created this solution to help overcome these problems.

You should drink __ Litre/s of St. Mark’s Solution per day. (staff to insert number)

How to make St. Mark’s Solution

All the ingredients can be bought from supermarkets or community pharmacies for less than one prescription charge.

*If you cannot get sodium bicarbonate or sodium citrate powder, this is replaced with 30mL of sodium citrate 0.3M oral solution. If you need advice, please contact your doctor or dietician. See the contact details.

1. Measure the ingredients into a suitably sized container.
2. Mix and dissolve the ingredients in 1 Litre (1000mLs) of cold tap water
3. The advised amount should be sipped throughout the day
4. The solution must be thrown away after 24 hours and a new solution made the following day

What if I don’t like the taste?

You can improve the taste by:

• storing in the fridge and drinking it chilled
• freezing the solution into ice cubes and drinking as a slush
• adding a small amount of fruit juice or squash when making the whole solution (avoid mixing the ready-made solution with juice when adding to each glass as the sodium content changes)
• drinking through a straw.

If taste continues to be an issue, try sodium citrate powder instead of sodium bicarbonate powder.

Managing your stoma output

Drinking too much fluid can increase your stoma output and make you even more dehydrated. In warmer conditions, we sweat more and lose more fluids as well as electrolytes, you may find that you need to drink more of this oral rehydration solution. Your output can be reduced by:

• limiting the amount of ordinary fluids you drink (for example, coffee, tea, water, fizzy drinks) to about 1 litre (1000mL). This is about six medium cups each day
• drinking St. Mark’s to help your body absorb salt and water
• medication
• eating and drinking the correct diet for you.

Useful contacts

Contact your consultant, GP or specialist nurse to request a dietetic referral. Alternatively, please contact the Dietetic Department on 01305 254415 to discuss a referral.

About this leaflet

Authors: Jamie Singleton and Ursula Gotel
Written: May 2024
Approved: May 2024
Review date: May 2027
Edition: v1

If you have feedback regarding the accuracy of the information contained in this leaflet, or if you would like a list of references used to develop this leaflet, please email patientinformation.leaflets@dchft.nhs.uk