Effect of Thickening Agents on Stoma Output in Patients With High-Output Enterostomies: A Retrospective Analysis

High-output stoma (HOS) is a frequent postoperative complication causing fluid, electrolyte, and nutrient losses. Soluble fibres such as xanthan gum and guar gum may reduce effluent volume and improve consistency, although clinical evidence remains limited. This study evaluates a thickening powder containing maltodextrin, xanthan gum, and guar gum for reducing enterostomy output.

This retrospective observational study evaluated the effect of a thickening powder composed of maltodextrin, xanthan gum, and guar gum on enterostomy output in patients with newly created terminal ileostomies or jejunostomies. Data from 78 patients treated at a single tertiary centre were reviewed, of whom 14 received the thickening powder during hospitalization. Enterostomy output was measured before and after powder administration under stable dietary and fluid conditions. Statistical analysis using paired t-test and Wilcoxon signed-rank test assessed the significance of observed changes.

Mean output decreased from 1285.6 mL (SD = 404.3 mL) to 1009.0 mL (SD = 188.7 mL) after intervention (p = 0.029 and p = 0.019, respectively), representing an average reduction of 276.6 mL corresponding to a ~21.5% reduction compared to baseline. (SD = 382.9 mL; 95% CI: 33.4-519.9 mL).

These results suggest that the thickening powder may effectively reduce enterostomy output. Although the study's retrospective design and small sample size limit the generalizability of findings, the results warrant further prospective, randomized research to confirm efficacy and support standardized postoperative management protocols.