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Transfusion in GI Bleeding — ESEGH MCQ

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HardHematologyTransfusion in GI BleedingESEGH

A patient with a jejunostomy outputs 3 litres daily and becomes thirsty, hyponatraemic and magnesium-depleted despite drinking large volumes of water. What is the best initial fluid strategy?

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Correct answer: A — Restrict hypotonic drinks and prescribe glucose–saline oral solution

In a high-output jejunostomy, hypotonic drinks drive further sodium and water loss into the lumen. Restricting these fluids and sipping an oral solution with about 90 mmol/L sodium promotes coupled sodium–glucose absorption; antimotility therapy and magnesium replacement are added.

Reference: BSG guideline for management of patients with a short bowel (Current BSG guidance, accessed 30 July 2026): https://www.bsg.org.uk/clinical-resource/guidelines-for-management-of-patients-with-a-short-bowel; NICE CG32: nutrition support for adults — recommendations (Updated August 2017): https://www.nice.org.uk/guidance/cg32/chapter/Recommendations