Prospective Evaluation of Individualized Nutrition Support on the Incidence of High-Output Ileostomy
6 affiliations
- 1Department of General and Visceral Surgery, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
- 2Department for Urology, Franziskus Krankenhaus, 10787 Berlin, Germany
- 3Institute of Biometry and Clinical Epidemiology, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- 4Department of Gastroenterology, Infectiology and Rheumatology, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin und Humboldt-Universität zu Berlin, 12203 Berlin, Germany
- 5Department for General, Visceral and Transplantation Surgery, University Medicine Augsburg, 86156 Augsburg, Germany
- 6Department of General, Visceral, and Oncological Surgery, St. George Hospital, 04129 Leipzig, Germany
Abstract
Background: Patients with an ileostomy are at risk of developing a high-output ileostomy (HOS). An episode of HOS can lead to dehydration and acute kidney injury (AKI). Existing dietary recommendations are largely based on expert opinion. At Charité—Campus Benjamin Franklin, a new interdisciplinary nutrition concept was developed for patients following ileostomy creation. Methods: This prospective, single-centre interventional study included adult patients undergoing elective surgery with the creation of an ileostomy between July 2022 and November 2024. The primary outcome was the incidence of post-discharge HOS occurring during the follow-up period. Patients received standardized postoperative meals and individualized dietary counselling. Outcomes were compared to a historical cohort. Results: Among 103 patients (44.2% female; median age 47.5 years), HOS occurred in 13 patients (12.6%; 95% CI 6.8–20.4%) during follow-up and in 41 of 296 patients in the historical cohort (13.9%; 95% CI, 10.4–18.3%). Patients (n = 23) developing HOS during hospitalization experienced no recurrence at follow-up. Readmission was more frequent in the HOS group (53.8% vs. 21.1%, p = 0.011), particularly due to AKI (46.2% vs. 5.6%, p < 0.001). Weight loss was also more common during follow-up in the group with HOS (76.9% vs. 35.6%, p = 0.005), with a median weight loss of 2 kg. Conclusions: HOS incidence was not different from that observed in the historical cohort; however, the study was not designed to establish equivalence or non-inferiority. The structured nutrition pathway was feasible to implement. Post-discharge HOS was associated with readmission, acute kidney injury, and weight loss.
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BibTeX
@article{strobel2026prospective,
title = {{Prospective Evaluation of Individualized Nutrition Support on the Incidence of High-Output Ileostomy}},
author = {Rahel M. Strobel and Stella Toepfer and Konrad Neumann and Kati Engel and Michael Schumann and Wael Rayya and Christian H. W. Schineis and Katharina Beyer and Arved Weimann and Johannes C. Lauscher},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18193301},
url = {https://europepmc.org/article/PMC/PMC13666628},
note = {CC BY},
}
RIS
TY - JOUR
TI - Prospective Evaluation of Individualized Nutrition Support on the Incidence of High-Output Ileostomy
AU - Rahel M. Strobel
AU - Stella Toepfer
AU - Konrad Neumann
AU - Kati Engel
AU - Michael Schumann
AU - Wael Rayya
AU - Christian H. W. Schineis
AU - Katharina Beyer
AU - Arved Weimann
AU - Johannes C. Lauscher
PY - 2026
DA - 2026/10/01
JO - Nutrients
DO - 10.3390/nu18193301
UR - https://europepmc.org/article/PMC/PMC13666628
AB - Background: Patients with an ileostomy are at risk of developing a high-output ileostomy (HOS). An episode of HOS can lead to dehydration and acute kidney injury (AKI). Existing dietary recommendations are largely based on expert opinion. At Charité—Campus Benjamin Franklin, a new interdisciplinary nutrition concept was developed for patients following ileostomy creation. Methods: This prospective, single-centre interventional study included adult patients undergoing elective surgery with the creation of an ileostomy between July 2022 and November 2024. The primary outcome was the incidence of post-discharge HOS occurring during the follow-up period. Patients received standardized postoperative meals and individualized dietary counselling. Outcomes were compared to a historical cohort. Results: Among 103 patients (44.2% female; median age 47.5 years), HOS occurred in 13 patients (12.6%; 95% CI 6.8–20.4%) during follow-up and in 41 of 296 patients in the historical cohort (13.9%; 95% CI, 10.4–18.3%). Patients (n = 23) developing HOS during hospitalization experienced no recurrence at follow-up. Readmission was more frequent in the HOS group (53.8% vs. 21.1%, p = 0.011), particularly due to AKI (46.2% vs. 5.6%, p < 0.001). Weight loss was also more common during follow-up in the group with HOS (76.9% vs. 35.6%, p = 0.005), with a median weight loss of 2 kg. Conclusions: HOS incidence was not different from that observed in the historical cohort; however, the study was not designed to establish equivalence or non-inferiority. The structured nutrition pathway was feasible to implement. Post-discharge HOS was associated with readmission, acute kidney injury, and weight loss.
SN - 2072-6643
ER -