Osmolality of Oral Supplements and Ileostomy Output

Does Osmolality of Oral Supplements Affect Stoma Output and Natriuresis in Patients With an Ileostomy?

This double-blinded, active comparator, cross-over intervention study tested the impact of two different oral supplements on ileostomy output volume and urinary sodium excretion and intestinal aquaporin expression in eight compensated patients with an ileostomy and not on home parenteral Nutrition or fluid support.

Patients with an ileostomy may experience fluid and electrolyte imbalances sedondary to an unregulated intestinal loss of water and electrolytes. The osmolality of oral supplements may affect these losses. In a double-blinded, active comparator, cross-over intervention study, the investigators test the effects of substituting 800 ml of the usual fluid intake with an intake of either an isoosmolar (300 mOsm/kg) or hyperosmolar (700 mOsm/kg) supplement during 48 hours, following baseline data collection before both intervention periods. Outcome measures were stoma output volume, 24-hour urine and urinary sodium excretion, and intestinal aquaporin 3 and 8 expressions.

Inclusion Criteria:

• age 18 years or more
• ilestomy established 6 weeks or more prior to inclusion
• able to drink at least 100 ml fluid per 24 hours
• i known inflammatory bowel disease, clinical remission judged by physician's global assessment (PGA)
• less than 5 kg self-reported weight change during the past 3 months

Exclusion Criteria:

• self-reported intolerance to dairy products, including lactose
• known renal insufficiency, defined by an eGFR less than 30 ml/min
• known diabetes mellitus, defined by an HbA1C > 48 mmol/mol (6.5%)
• current enteral tube feeding or parenteral fluid or Nutrition support more than twice weekly