Successful management of chronic high-output ileostomy with high dose loperamide

High-stoma output is a common problem that can lead to dehydration and electrolyte disturbance. The following report describes three patients with end ileostomy who had high-stoma outputs where conventional medical management was unsuccessful in controlling stoma output. All three patients responded to high-dose loperamide, resulting in significant clinical improvement. High-dose loperamide therapy should be considered in patients with high-stoma output who have failed conventional medical management.

[1]  L. Schiller,et al.  Studies of the mechanism of the antidiarrheal effect of codeine. , 1982, The Journal of clinical investigation.

[2]  P. Janssen,et al.  Mechanisms of action of loperamide. , 1984, Scandinavian journal of gastroenterology. Supplement.

[3]  Janssen Pa,et al.  Mechanisms of action of loperamide. , 1984 .

[4]  L. Schiller,et al.  Mechanism of the antidiarrheal effect of loperamide. , 1984, Gastroenterology.

[5]  D. Thompson,et al.  Effect of codeine and loperamide on upper intestinal transit and absorption in normal subjects and patients with postvagotomy diarrhoea. , 1988, Gut.

[6]  M. Levitt,et al.  High dose loperamide suppositories: a novel approach for improving clinical function after restorative proctocolectomy. , 1995, The Australian and New Zealand journal of surgery.

[7]  G. Tytgat,et al.  Effect of loperamide on fecal output and composition in well-established ileostomy and ileorectal anastomosis , 1977, The American Journal of Digestive Diseases.

[8]  J. Woodward,et al.  Guidelines for management of patients with a short bowel , 2006, Gut.

[9]  R. N. Williams,et al.  Causes and management of a high‐output stoma , 2011, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[10]  R. N. Brogden,et al.  Loperamide: A Review of its Pharmacological Properties and Therapeutic Efficacy in Diarrhoea , 2012, Drugs.

[11]  D. Manas,et al.  A practical approach to the management of high-output stoma , 2013, Frontline Gastroenterology.