S803 Optimization of Fluid and Electrolyte Status in Adult Patients With Ileostomy

Introduction: Ileostomy creation is a standard procedure among patients with colorectal cancer, diverticulitis, and inflammatory bowel disease (IBD). Surgical procedures that involve colonic resection can result in nutritional complications, leading to high rates of hospital readmission due to dehydration and acute kidney injury (AKI). While available perioperative nutrition literature focuses on short-bowel syndrome and high-output stoma, recommendations outside these conditions are sparse. Therefore, this scoping review aims to provide a comprehensive summary of oral rehydration solution (ORS) as a treatment for patients undergoing ileostomy, with the goal of preventing dehydration, AKI, and hospital readmission. Methods: We conducted literature searches in Medline, Agricola, Embase Classic, and Embase via Ovid, Scopus via Elsevier, and the Cochrane Library via Wiley, and included trials discussing nutritional management of adults who underwent ileostomy for gastrointestinal (GI) disorders and diseases. Results: We identified 5,738 articles; 6 studies were eligible. Studies compared treatment with ORS to controls for patients undergoing ileostomy for various GI conditions (IBD, cancer, Hirschsprung’s disease, diverticulitis, sigmoid volvulus, and constipation) and were heterogeneous in design. Collected data included biochemical indicators (4 studies), stomal output (3 studies), hospital readmission (2 studies), and qualitative ORS assessment (2 studies). Overall, ORS administration improved fluid/electrolyte balance across all 4 trials, reduced stomal output in one trial, and decreased dehydration/AKI-related hospital readmission rates by 24% and 29.2% in 2 separate trials, respectively. Qualitatively, ORS taste and texture emerged as a critical determinant of patient adherence. Conclusion: A standardized ORS intervention represents a low-cost, accessible approach to improve fluid/electrolyte balance, reduce hospital readmissions, and preserve kidney function in patients with new ileostomies. The findings, however, are limited by methodological heterogeneity, and further research is needed to determine the optimal composition, volume, and timing of ORS. Patient-led appraisals of palatability should also be investigated to optimize adherence. As a low-cost and potentially highly efficacious treatment modality, perioperative nutrition management with ORS has tremendous potential to improve both immediate and long-term health outcomes for this vulnerable yet often overlooked patient population.