Year 4middle twist
A 60-year-old man with a history of chronic diarrhea presents with muscle weakness and lethargy. Laboratory tests show: potassium 3.1 mmol/L (3.5-5.0 mmol/L), bicarbonate 17 mmol/L (22-28 mmol/L), arterial blood pH 7.28 (7.35-7.45). His blood glucose is normal. Which of the following is the most likely explanation for his metabolic acidosis in the context of hypokalemia?