Safe management of ileostomates with high-output stomas

An ileostomy is where the small bowel is diverted to the abdominal surface resulting in the formation of a stoma. An Ileostomy can be temporary or permanent and produces loose faeces. Some ileostomates can develop high output in the early postoperative stage. Most will resolve, some will require ongoing treatment and management. While patients are monitored closely according to protocol in hospital once discharged into the community, there appears to be little standardisation. A literature search revealed that existing guidelines are for management of patients in the acute care setting. However, if not adequately prepared and monitored, patients with prolonged high output are at risk of complications including dehydration, acute kidney injury and malnutrition. This article discusses the development of a guideline aimed at improving education, monitoring and ultimately improving outcomes for patients with high-output stomas in the community.