Obstructive and secretory complications of diverting ileostomy

Table 2 Causes and risk factors of high output stoma

Causes and risk factors of high output stoma
Patient
1Older age[42,48]
1Higher ASA-PS[48]
1Elevated baseline creatine[48]
Disease
1Diabetes[43]
Inflammatory bowel disease (i.e., ulcerative disease, Crohn’s disease)[29,42,43]
Anatomy
Short bowel (less than 200 cm)[29]
Surgical procedure
Open surgery (vs laparoscopic surgery)[42,48]
Total proctocolectomy (with ileal-pouch anal anastomosis)[42]
Right-side colectomy[42]
Separate ileostomy[42]
Small bowel resection[29,42,43]
Medication
Preoperative use of diuretics[31,33]
Prokinetic drugs (i.e., metoclopramide)[29,31]
Sudden withdrawal of corticosteroids or opiates[29,31]
Postoperative adjuvant chemotherapy[29]
Nutrition
Hypotonic liquids (low sodium): water, tea, coffee, fruit juice, alcohol[29,30,31]
Enteritis/metabolism
Clostridium difficile infection[29,50]
Salmonella infection[29,50]
Bacterial overgrowth from diverticula or blind loop fermentation[29,50]
Relative to postoperative complications
Postoperative ileus (symptoms of nausea, vomiting, intolerance to oral feeding, abdominal distension, or failure to pass flatus or bowel movements within postoperative 7 d)[44]
Intra-abdominal sepsis (pelvic sepsis, organ/space infection)[29,49]
Small bowel obstruction[29]
Stoma outlet obstruction[49]

¹No specific values or definitions were shown in the referenced articles. ASA-PS: American Society of Anesthesiologists-physical status.