Tackling catabolic state in high output stoma cases: our experience with enriched stoma content refeeding

Background: Patients who have a high output stoma are prone to fluid and electrolyte imbalance and the expensive parenteral nutrition (PN) is necessary for management. In these cases, re-feeding can be beneficial with enriched stoma effluent. Methods: In our study we included 25 cases which had high output stoma with maximum bowel length of 140 cm from duodeno-jejunal junction or output greater than 1.5l in 24 hours. Results: Among these 25 cases, 16 were males and 9 females. The most common indications for making stoma were intestinal perforation (11) and gangrene (6). These cases were discharged on enriched re-feeding. No major complications were associated with re-feeding. None of the patients required parenteral nutrition after discharge from hospital. After getting body mass index (BMI) and serum albumin under normal parameters, we were able to close the stomas in all the patients. Conclusions: Patients with high output stoma can be managed nutritionally with distal enriched re-feeding. It is a cost-effective and effective alternate for parenteral nutrition (PN), which is associated with complications.