From the Guidelines
The recommended daily ileostomy output to maintain is typically between 500-1000 mL per day. This amount represents a healthy balance that prevents dehydration while ensuring adequate waste elimination. If output exceeds 1500 mL per day, this is considered high output and may lead to dehydration, electrolyte imbalances, and nutritional deficiencies.
Key Considerations
- To maintain appropriate output levels, patients should consume 2-3 liters of fluid daily, focusing on electrolyte-rich options like sports drinks or oral rehydration solutions rather than plain water 1.
- Dietary modifications can help control output, including consuming a low-fiber diet, eating smaller meals more frequently, and avoiding foods that increase output such as spicy foods, caffeine, alcohol, and high-sugar items.
- Medications that may help regulate high output include loperamide (Imodium) 2-4 mg taken 30 minutes before meals and at bedtime, diphenoxylate-atropine (Lomotil), or cholestyramine 1.
Monitoring and Management
- Monitoring output volume, consistency, and color is essential, as is tracking urine output and weight to detect early signs of dehydration.
- If output consistently exceeds 1500 mL daily despite these measures, medical attention should be sought promptly.
- Early follow-up of patients with high output stoma after discharge can result in a significant reduction in the rate of readmissions and allow identification of a high percentage of patients with malnutrition 1.
From the Research
Ileostomy Output Recommendations
The recommended daily amount of ileostomy output to maintain can vary.
- According to a study published in 2021 2, an established ileostomy output varies between 600-800 ml per day.
- Another study from 1975 3 found that patients with an established ileostomy following proctocolectomy had daily faecal volumes of 401 +/- 92 ml with minimal ileal resection, and 1202 +/- 284 ml with significant ileal resection.
- A 2016 article 4 discusses the management of ileostomates with high-output stomas, but does not provide a specific recommended daily output.
Factors Affecting Ileostomy Output
Several factors can affect ileostomy output, including:
- The amount of ileum resected 3
- The use of medications such as loperamide, which can reduce ileostomy output 5
- The application of oral rehydration solution to maintain water and electrolyte balance 6
Comparison of Options
Comparing the options provided:
- A. 500-700 mL: This range is within the variation of established ileostomy output mentioned in the 2021 study 2.
- B. 250- 500mL: This range is lower than the variation of established ileostomy output mentioned in the 2021 study 2.
- C. 750 – 1000 mL: This range is higher than the variation of established ileostomy output mentioned in the 2021 study 2.
- D. 1500 mL: This is higher than the variation of established ileostomy output mentioned in the 2021 study 2 and may be considered high output.