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.
