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High-output stoma — ESEGH MCQ

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HardNutritionHigh-output stomaESEGH

A 48-year-old man has a high-output jejunostomy after emergency small-bowel resection. Stoma output is 3.2 L/day and he is dizzy on standing. Sodium is 129 mmol/L, magnesium 0.48 mmol/L and urine sodium is 8 mmol/L. He drinks large volumes of water because of thirst. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Restrict hypotonic fluids and prescribe high-sodium oral rehydration solution

High-output stoma causes sodium and water depletion; hypotonic fluids worsen losses, while glucose-saline oral rehydration promotes sodium absorption. Plain water can increase stomal sodium loss. Lactulose would worsen output. The pearl is that urine sodium is a useful marker of depletion in intestinal failure.

Reference: BSG Short Bowel and Intestinal Failure Guidance; NICE Nutrition Support CG32