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Pharmacological Strategies for High-Output Ileostomies in Children: A Narrative Review

Marijke Awouters1, Tim Vanuytsel2, Pauline De Bruyne3

  • 1Department of Paediatrics, University Hospitals Leuven, Leuven, Belgium.

Acta Paediatrica (Oslo, Norway : 1992)
|January 22, 2025
PubMed

Insights

Pharmacological management for high-output ileostomy (HOI) in children is limited, with little evidence supporting its use. Further research is needed to validate treatment options for paediatric patients with HOI.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Pharmacology
  • Surgical Patient Management

Background:

  • High-output ileostomy (HOI) in pediatric patients often requires pharmacological intervention beyond nutritional management.
  • Limited evidence exists for the pharmacotherapy of HOI in children.

Purpose of the Study:

  • To review the current literature on the pharmacological management of pediatric HOI.
  • To formulate evidence-based recommendations for treating pediatric HOI.

Main Methods:

  • Comprehensive literature search of PubMed and Embase databases.
  • Review of identified articles to formulate clinical recommendations.

Main Results:

  • No dedicated pharmacological studies in pediatric HOI patients were found, except for two case reports on octreotide.
  • Recommendations are extrapolated from adult data and other intestinal failure conditions.
  • Primary recommendations include proton pump inhibitors and loperamide; octreotide for persistent complications; codeine with caution in older children.

Conclusions:

  • Pharmacological treatment options for pediatric HOI are scarce, with a significant lack of supporting evidence.
  • There is a critical need for dedicated research to validate pharmacotherapy in this vulnerable patient population.
Abstract

Keywords:
childrenhigh outputileostomypharmacotherapy

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