A high-output stoma

A high-output stoma is one producing more than roughly a litre to a litre and a half in twenty-four hours, though the exact definition varies between hospitals. It matters because that much loss carries a real risk of dehydration, of electrolytes going out of range and of harm to the kidneys. This is a different problem from the ones the rest of this diet addresses. It is about what is leaving, not about what might catch.

What the guidance emphasises

Fluid and salt first, food second. The counter-intuitive part is that drinking more plain water can make output worse rather than better, because a dilute drink prompts the gut to give up more salt and water in return. The advice is therefore to use an isotonic drink or an oral rehydration solution instead, to sip fluids between meals rather than with them, and to salt food generously.

On the food side, the emphasis falls on starches that absorb water and slow transit: white rice, white pasta, mashed potato, white bread and ripe banana. This is also where the trusts disagree most sharply about oats and peanut butter, both of which some hospitals recommend here as thickeners while the leaflet this book follows leaves them out.

What this book does

Recipes tagged for a high-output stoma are the thickening ones, built on collapsed rice, mashed potato, white bread and banana, and mostly small enough to eat often. Thickening stoma output is the technique page. Where a dish is rich in milk or fruit juice and might loosen things, the recipe says so.

How long

High output is usually treated actively rather than waited out, often with medicines that slow the gut alongside the diet, and it is your stoma nurse, dietitian or surgical team who set the targets and decide when things ease.

Output that stays high, dark and scant urine, dizziness on standing, or a stoma that stops producing anything at all, are reasons to contact your stoma nurse or team now rather than to change what you cook.