A person with a stoma may develop a high output stoma, sometimes called a high output ileostomy. It results in an atypically high output of liquids, which can cause dehydration. Fluid replacement and medications may be necessary.

Doctors may recommend an ileostomy to fit a stoma after an injury or for a health condition that prevents the large bowels from evacuating waste.

A stoma is an opening in the abdomen that can be connected to the digestive tract for the output of stools and waste from the body. Some people may develop a high output stoma.

This article discusses what a high output stoma is, its symptoms, and what can cause it. It also discusses management, risk factors, and possible complications.

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The typical output of a stoma is 600–1,200 milliliters per day (mL/day) of excretion.

Doctors typically identify high output stomas as those with an output of more than 2,000 mL/day or more than 1,500 mL/day for 2 or more consecutive days.

The output of a high output stoma is great enough to potentially cause dehydration because of the significant excretion of water and sodium.

A high output stoma occurs in about 31% of small bowel stomas, according to a 2022 review.

The symptoms of a high output stoma may include:

A high output ileostomy may have various causes.

One reason may be the reduced length of the intestine. This typically occurs in people who have the length of their bowels shorter than 200 centimeters (cm).

Other possible causes include:

  • Infection or sepsis: After the creation of the stoma, people may experience infections, including sepsis. This may happen due to edema, or swelling of the stoma, which may lead to obstruction.
  • Obstruction: In some cases, people with a stoma may experience partial obstruction of the bowels. This narrowing usually occurs near the stoma.
  • Medications: The side effects or withdrawal effects of certain medications, such as metoclopramide and cortisol, may cause some changes in bowel movements. This may increase the output of the stoma.
  • Recurrent disease: Certain conditions can contribute to increasing the excretion output. This includes internal fistula, small bowel diverticula, and celiac disease. However, after treating these conditions, the high output stoma should resolve.

Replacing fluids may be one of the first steps following a high output stoma diagnosis to reduce dehydration. This can include intravenous (IV) fluids. The stoma output may also be reduced during this time.

Doctors may recommend a person with a high output stoma sip a glucose-saline rehydration solution throughout the day. It can reintegrate the liquids and salts that are lost through the stoma.

A doctor may also prescribe medications, such as proton pump inhibitors (PPIs), to reduce the secretion of the pancreas and stomach. This can reduce the amount of liquid present in the bowels and reduce the excretion from the stoma.

Learn more about PPIs.

Certain surgical procedures and underlying conditions may increase the risk of a high output stoma.

Surgical procedures that may increase the risk of a high output stoma include:

  • left-sided colectomy
  • procto-colectomy
  • right-sided colectomy
  • ileal pouch-anal anastomosis (IPAA)
  • sole ileostomy
  • small bowel resection

Conditions that may increase the risk of a high output stoma include:

A person can contact their doctor if they have any concerns about the risk factors for a high output stoma.

People with a high output stoma may experience some complications, including:

Contacting a doctor as soon as symptoms of a high output stoma occur can help a person reduce their risk of complications.

Learn more about dehydration.

A person should contact a doctor as soon as they have concerns about a high output stoma. A doctor can advise on ways to manage the condition.

A person with a high output ileostomy should promptly contact their doctor if any of the following occurs:

  • fever
  • blood coming from the inside of the ileostomy
  • blood in the stoma bag
  • signs and symptoms of dehydration
  • severe cramps, nausea, and vomiting

These may be symptoms of a serious infection or obstruction in the bowels and needs medical attention.

If a person has any concerns about their health, they should contact a doctor.

After a person has an ileostomy to fit a stoma, a high output stoma may develop. This can cause dehydration and other complications, such as malnutrition.

People with a high output ileostomy may have to change their lifestyle and diet. Doctors may recommend fluid replacement, glucose-saline rehydration solutions, and medications.

People with a high output stoma may also experience infections and blockages in their bowels. If this occurs, they may experience fever, nausea, and cramps. If a person suspects a blockage or an infection of their stoma, they should immediately contact a doctor.