This leaflet answers common questions about the prevention and management of dehydration in relation to a high output stoma. Stoma output can sometimes increase due to changes in temperature (hot weather), coughs and colds or other illnesses, changes in diet or medications.

If your stoma output remains high or watery after following this advice, then please contact your stoma care or colorectal cancer clinical nurse specialist (CNS) for advice.  

What is a high output stoma? 

A high output stoma will depend on the type of stoma you have but generally will be considered if: 

  • Jejunostomy/Ileostomy output is more than 1500ml/24 hours for more than two consecutive days 
  • Colostomy output is more than 1000ml/24 hours for more than two consecutive days 

What consistency should my poo be? 

  • Colostomy: a soft to thick, formed poo. 
  • Jejunostomy/Ileostomy: a loose to thick porridge like consistency 
     

Why it’s important to know your stoma output

A high output stoma or change in consistency of your output can mean that you are not absorbing all the essential nutrients and fluids your body needs. This will put you at a high risk of becoming dehydrated and malnourished. 

Dehydration symptoms

If you are dehydrated, you may experience: 

  • Dry mouth, lips, and/or tongue  
  • Increased thirst 
  • Dark yellow, strong-smelling pee  
  • Light headedness or feeling dizzy, especially when going from sitting to standing 
  • Fatigue 
  • Headache 
  • Muscle cramps 
  • Pee less than normal 

If you have any of these symptoms, then it is important to note any changes in your stoma output and/or consistency. 

How to prevent dehydration

Diet

  • Reducing the fibre in your diet can reduce the amount of: 
  • Eat a low fibre diet: white bread, white cereals, white rice, white pasta. 
  • Fruit and vegetables: Small portions of fruit and vegetables with skins and seeds removed.
  • Beans and pulses: Limit your intake of pulses (beans, chickpeas, or lentils) unless you are vegetarian when you should include one portion a day for protein. 
  • Eat slowly and chew your food well.at regularly and do not skip meals to encourage a regular output  
  • Sometimes eating smaller meals but more frequently can help regulate output and decrease bloating/wind. 
  • Increase your salt intake 
     

Fluid intake

Drinking too much “ordinary fluids” (eg. water, fruit juice, tea, and coffee) can increase your stoma output, making you more thirsty and more dehydrated: 

Limiting those drinks and replacing them with oral rehydration solutions (eg. Lucozade Sport or St Mark’s solution if this has been prescribed for you) will help your body reabsorb fluid and salt. 

When the weather is hot, we tend to sweat more, and this increases the loss of salt and fluid from the body. For you to replace these salts and fluid you should drink more oral rehydration solutions rather than ordinary fluids. 

If you have been given a fluid allowance, (usually 500ml to 1000ml or ordinary fluids) then it is important to stick to this especially when you are feeling thirsty. 

Medications

You may have been prescribed some medications to help with your stoma output. It is important to take them at the correct times in relation to your meals eg. Loperamide should be taken 30 minutes before food.   

If you’re feeling dehydrated and noticed changes in your stoma output

If you have noticed changes in your stoma output, as listed above, and are experiencing any of the symptoms of dehydration despite following the diet and fluid guidance, then contact your stoma care or colorectal CNS for further advice.