A systematic approach in the management of a high output ileostomy resulting in a favorable clinical outcome

High output ileostomy is not uncommon and when diagnosed, it should be managed expeditiously and systematically in order to prevent complications such as dehydration, electrolyte disturbance and acute kidney injury.

A multi modal regimen consisting of correction of fluid and electrolyte deficit; restriction of oral hypotonic fluids with dietary modifications and use of anti-motility drugs was sequentially and concomitantly introduced to achieve a favourable clinical outcome. Patient education regarding dietary modifications and recognition of dehydration due to high output stoma is paramount. A co-ordinated multi-disciplinary approach involving the patient, family, dietician, community nurses and hospital doctor is vital.