ArticleFrontline gastroenterology2022
How to manage a high-output stoma.
Article in Frontline gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Guideline
- Clinical management of high-output stoma: a systematic literature review and meta-analysis.Techniques in coloproctology · 2023Pooled it
- Risk factors and prediction model for early high-output stoma after colorectal cancer surgery: A retrospective study.Asia-Pacific journal of oncology nursing · 2026Article
- National Prescribing Patterns in Stoma Care Across the United Kingdom: A Prescription Cost Analysis with Health Policy Implications.Healthcare (Basel, Switzerland) · 2026Article
- Diagnosing and Managing the High-Output Ileostomy: A Comprehensive Narrative Literature Review.Digestive diseases and sciences · 2026Review
- [How do individualized stoma diets and nutritional counselling in the inpatient setting influence patient adherence and satisfaction?]Chirurgie (Heidelberg, Germany) · 2026Article
- Clinical factors associated with early high-output stoma and 30-day readmission: a retrospective cohort study.Updates in surgery · 2026Article
- Gangrenous cecal volvulus with 720° torsion and prolonged intraoperative hypotension in a resource-limited setting: a case report.Annals of medicine and surgery (2012) · 2026Article
- Bioactivity Assessment and In Silico Target Engagement ofFood science & nutrition · 2026Article
- When nothing else matters: proctectomy for complex perianal Crohn's disease-indications, timing, techniques, and outcomes.Techniques in coloproctology · 2026Review
- Implementation and Clinical Impact of a Structured Clinical Pharmacy Service for Hospitalized Ileostomy Patients: A Retrospective Observational Study Using the RE-AIM Framework.Pharmacy (Basel, Switzerland) · 2026Article
- Puncture and catheterization of the ascending colon for succus entericus reinfusion in a patient with a high-output single-lumen stoma: a case report.BMC surgery · 2026Article
- Study of Treatment with Intensified Omeprazole to Prevent High-Output Stoma-A Protocol for a Randomized, Parallel-Group, Open-Label, Superiority Trial in Adults Undergoing Ileostomy (STOP-HOS-1).Journal of clinical medicine · 2026Article
- A transmesenteric hernia as a reason for small bowel obstruction in an adult: a case report.International journal of surgery case reports · 2026Article
- Revisiting the need for innovative oral hydration technologies.Frontiers in nutrition · 2026Review
- Aldosterone-identified targets for optimal sodium and potassium supplementation in intestinal failure.Frontiers in nutrition · 2026Article
- Strategies for Managing Fluids and Electrolytes in High-Output Stomas: A Systematic Review and Evidence Summary.Journal of multidisciplinary healthcare · 2026Review
- Advances in Nutritional and Therapeutic Strategies for Type 2 Intestinal Failure: A Narrative Review.Nutrition reviews · 2025Review
- Severe Acute Kidney Injury Associated With Intestinal Ostomies.Kidney medicine · 2025Article
- Stomal Hyperflow and Intestinal Failure: A Case Report on the Use of a Chyme Reinstillation Device.Cureus · 2025Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A high-output stoma (HOS) or fistula is when small bowel output causes water, sodium and often magnesium depletion. This tends to occur when the output is >1.5 -2.0 L/24 hours though varies according to the amount of food/drink taken orally. An HOS occurs in up to 31% of small bowel stomas. A high-output enterocutaneous fistula may, if from the proximal small bowel, behave in the same way and its fluid management will be the same as for an HOS. The clinical assessment consists of excluding causes other than a short bowel and treating them (especially partial or intermittent obstruction). A contrast follow through study gives an approximate measurement of residual small intestinal length (if not known from surgery) and may show the quality of the remaining small bowel. If HOS is due to a short bowel, the first step is to rehydrate the patient so stopping severe thirst. When thirst has resolved and renal function returned to normal, oral hypotonic fluid is restricted and a glucose-saline solution is sipped. Medication to slow transit (loperamide often in high dose) or to reduce secretions (omeprazole for gastric acid) may be helpful. Subcutaneous fluid (usually saline with added magnesium) may be given before intravenous fluids though can take 10-12 hours to infuse. Generally parenteral support is needed when less than 100 cm of functioning jejunum remains. If there is defunctioned bowel in situ, consideration should be given to bringing it back into continuity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.