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Curriculum Based Clinical Reviews
A practical approach to the management of high-output stoma
  1. Christopher G Mountford1,
  2. Derek M Manas2,
  3. Nicholas P Thompson1
  1. 1Department of Gastroenterology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  2. 2Institute of Transplantation, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  1. Correspondence to Dr Christopher G Mountford, Department of Gastroenterology, Freeman Hospital, High Heaton, Newcastle upon Tyne NE7 7DN, UK; c.mountford{at}


The development of a high-output stoma (HOS) is associated with water, electrolyte and nutritional complications. Prompt, careful assessment and management is required to avoid rapid clinical deterioration in this patient population. A multidisciplinary approach to management ensures the best possible outcome and quality of life for patients who experience HOS. This article outlines the important considerations in the identification and pathophysiology of HOS. A systematic approach to the management of the condition is outlined, considering fluid and electrolyte requirements, nutrient deficiencies and manipulation of gastrointestinal absorption, motility and secretions using medical and surgical therapies.


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