Overview

This information gives guidance about fluids and diet to help manage a high-output stoma.

A stoma is an opening made during surgery through the tummy (abdominal) wall. It can be connected to your digestive or urinary system.

If you have a stoma, waste (poo or urine) will not pass out of the body in the usual way. Instead, it goes into a collection bag that you wear over the stoma.

After your surgery, you may have problems with a high-output stoma. This is when the stoma output is more than 1 litre each day. Having a high output means that:

• food and drink pass quickly through your bowel
• your body may not take in (absorb) nutrients, fluids and salts well

With time, your bowel may start to absorb nutrients better. Your stoma output may then start to thicken and reduce.

High losses of fluid from your stoma can cause:

• severe dehydration (lack of water in your body)
• imbalances of nutrients or electrolytes (salts and minerals found in the blood)
• weight loss

This information covers:

• the amounts and types of fluid that you need to drink 
• the timings and types of food that you need to eat 
• medicines that may help to reduce your stoma output 
• common concerns if you have a high-output stoma 

If you have any questions, please contact the nutrition and dietetics department.

Fluids

Drinking too much ordinary fluid can:

• increase your stoma output
• make you become more dehydrated and thirsty

When your stoma output increases, you lose fluids, nutrients and electrolytes (salts and minerals found in the blood). The main electrolytes that you lose with a high-output stoma are:

• sodium
• potassium
• magnesium salts

Here is some guidance to help reduce your stoma output and prevent you from losing fluids, nutrients and electrolytes:

Oral rehydration solution

Oral rehydration solution is a specially made salty and sweet drink.  It helps your bowel to take in water and salts from the food and fluid that you have. This helps to reduce your stoma output and keep you hydrated.

Check with your doctor, dietitian or nutrition nurse whether you need potassium salts to be included in your oral rehydration solution.

Oral rehydration solution can be prescribed for you as Dioralyte^® sachets. You can buy them from a pharmacy, supermarket or shop.

Otherwise, we might recommend that you have a potassium-free oral rehydration solution. This is because the level of potassium (a mineral) in your blood might have increased at some point.

If you need potassium-free oral rehydration solution, we will give you this in hospital. When you are at home, you can make it using this recipe:

• 6 flat (level) 5ml teaspoons of glucose
• 1 level 5ml teaspoon of salt
• half a heaped 5ml teaspoon of sodium bicarbonate

You can buy all these ingredients from a pharmacy, supermarket or health food shop. You need to follow these instructions:

• Dissolve the ingredients in 1 litre of cold tap water.
• Sip the prescribed amount throughout the day.
• Throw the solution away within 24 hours and prepare a fresh solution the next day.

You may find that the solution tastes salty. Here are some tips to help with this: