What are your go-to medical management options for high ileostomy output in patients with >100 cm of remaining small bowel?
What do you recommend in refractory cases?
Answer from: at NCI-Designated Cancer Center
First of all, you have to make sure that the patient's liquid intake is not composed of free water but an electrolyte solution at least 50% of the time.
Metamucil at night
Nana flakes in a milkshake at night
Medication stepwise:
Maximize loperamide
Add diphenoxylate
Add a PPI to reduce a...
Comments
at Kaiser Permanente South Bay Medical Center Excellent recommendations. Very helpful.
Short gut can lead to hypergastrinemia; so check the gastrin level and give high-dose PPI or K-channel blocker if indicated. Somatostatin might help reduce secretion; Ceralyte could boost absorption.
Excellent recommendations. Very helpful.