TPW 1.18 Assessing High Output Stoma Management in a Busy District General Hospital
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ID: 323898
2026
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Abstract
Abstract Background and Aims A high output stoma (HOS) is reported to occur in up to 31% of new ileostomies, which can result in patient dehydration and electrolyte loss. Early appropriate management can reduce length of stay, incidence of acute kidney injury (AKI) and improve challenging stoma care. This audit aimed to assess compliance with our local guidance. Methods A retrospective audit of HOS management in general surgical patients between 01/07/2025 - 01/10/2025 was conducted against our local standards: investigations, fluid restriction, and prescribed medications and isotonic fluid where appropriate. The electronic patient record was scrutinised, and data were analysed in Microsoft Excel. Results 17 patients were identified. 17/17 (100%) patients had ileostomies. Patients had a median length of stay of 17 days (5-141 days) and 6/17 (35.3%) of patients developed an AKI. Whilst all patients had daily blood tests, no patient had the complete set. Commonly missed were bone profile 7/17 (41.2%), magnesium 6/17 (35.3%), vitamins A, E 17/17 (100%) and D 16/17 (94.1%) and urinary sodium 14/17 (82.4%). 15/17 (88.2%) had appropriate loperamide doses. 13/17 (76.5%) had the appropriate codeine dose. 9/17 (52.9%) had an orodispersible proton pump inhibitor. 9/17 (52.9%) had a fluid restriction. 9/17 (52.9%) had isotonic fluids prescribed. Conclusion Our local guidance is not being adhered to with varying practice for management and monitoring of HOS. This could lead to poorer outcomes for patients with HOS. A survey has been performed to shape clinician education to improve audit compliance.
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openalex_W7172532334
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| Authors | Emily Robinson, Jayan George, Isha Bashir, EeVone Lee, Matthew Wane, Simon Gonsalves |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.300
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| URL | |
| Keywords | Keywords not found |
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