Document Detail


Causes and management of a high-output stoma.
MedLine Citation:
PMID:  19888956     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Patients with a high-output stoma (HOS) (> 2000 ml/day) suffer from dehydration, hypomagnesaemia and under-nutrition. This study aimed to determine the incidence, aetiology and outcome of HOS.
METHOD: The number of stomas fashioned between 2002 and 2006 was determined. An early HOS was defined as occurring in hospital within 3 weeks of stoma formation and a late HOS was defined as occurring after discharge.
RESULTS: Six-hundred and eighty seven stomas were fashioned (456 ileostomy/jejunostomy and 231 colostomy). An early HOS occurred in 75 (16%) ileostomies/jejunostomies. Formation of a jejunostomy (defined as having less than 200 cm remaining of proximal small bowel; n = 20) and intra-abdominal sepsis? obstruction (n = 14) were the commonest causes identified for early HOS. It was possible to stop parenteral infusions in 53 (71%) patients treated with oral hypotonic fluid restriction, glucose-saline solution and anti diarrhoeal medication. In 46 (61%) patients, the HOS resolved and no drug treatment was needed, 20 (27%) patients continued treatment, six (8%) of whom went home and continued to receive parenteral or subcutaneous saline, and nine died. Twenty-six patients had late HOS. Eleven were admitted with renal impairment and four had intermittent small-bowel obstruction. Eight patients were given long-term subcutaneous or parenteral saline and two also received parenteral nutrition. All had hypomagnesaemia.
CONCLUSION: Early high output from an ileostomy is common and although 49% resolved spontaneously, 51% needed ongoing medical treatment, usually because of a short small-bowel remnant.
Authors:
M L Baker; R N Williams; J M D Nightingale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  13     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-24     Completed Date:  2011-05-18     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  191-7     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Colostomy
Dehydration / etiology
Humans
Hypercalciuria*
Ileostomy
Jejunostomy
Magnesium / blood
Middle Aged
Nephrocalcinosis*
Postoperative Complications
Renal Tubular Transport, Inborn Errors*
Surgical Stomas*
Chemical
Reg. No./Substance:
I38ZP9992A/Magnesium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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