You’re caring for Carin who has just had ileostomy surgery. During the first 24 hours post-op, how much drainage can you expect from the ileostomy?
A. 100 ml
B. 500 ml
C. 1500 ml
D. 5000 ml
Correct Answer: C. 1500 ml
The large intestine absorbs large amounts of water so the initial output from the ileostomy may be as much as 1500 to 2000 ml/24 hours. Gradually, the small intestine absorbs more fluid, and the output decreases. The major function of the small intestine is to absorb the body’s nutrients and water. Enzymes released into the small intestine break food into small particles so that vitally needed proteins, carbohydrates, fats, vitamins, and minerals can be absorbed.
Option A: 100 ml is too low an amount for ileostomy drainage. There are occasions when the ileostomy does not function for short periods of time. This is normal. However, if the stoma is not active for 4 to 6 hours and is accompanied by cramps and/or nausea, the intestine could be obstructed. An obstruction (or blockage) may be partial; that is, some liquid may pass through.
Option B: Loose stool can come from eating certain foods and is usually temporary. Raw fruits and vegetables, milk, fruit juice, prune juice, or contaminated drinking water are examples. Loose stool may also be caused by emotional stress. Some people with ileostomies may always have “watery discharge” and this is normal for them. 800-1,000 cc/day is normal for an ileostomy.
Option D: A drainage of 5000 ml in the first 24 hours may dehydrate the patient. Dehydration is a common concern with symptoms of increased thirst, dry mouth, decreased urine output, and fatigue. Increase any type of fluids such as Pedialyte® which is high in potassium and sodium. Avoid high-sugar drinks which can cause osmotic diarrhea. Daily intake of fluids should be 8-10 (8 oz.) glasses.
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