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Short bowel syndrome — ESEGH MCQ

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HardNutritionShort bowel syndromeESEGH

A patient with a 2.2 L/day jejunostomy output remains thirsty and hyponatraemic while drinking 3 L of water daily. Obstruction and infection are excluded. Which oral-fluid prescription best improves net sodium and water absorption?

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

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Correct answer: D — Use 90 mmol/L glucose-saline and restrict hypotonic drinks

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · B = shown as D · C = shown as E

B is correct. Jejunal losses contain substantial sodium; hypotonic water promotes luminal sodium movement and higher output, whereas glucose-saline solution at 90 mmol/L sodium or more supports coupled absorption. A worsens depletion. C is hyperosmolar and may increase output. D is too sodium-poor. E combines rapid drinking with meals rather than slow sipping.

Reference: UK practical approach to high-output stoma management: https://pmc.ncbi.nlm.nih.gov/articles/PMC5369744/