PT - JOURNAL ARTICLE AU - R N Williams AU - D Hemingway AU - A S Miller TI - Enteral <em>Clostridium difficile</em>, an emerging cause for high-output ileostomy AID - 10.1136/jcp.2008.062901 DP - 2009 Oct 01 TA - Journal of Clinical Pathology PG - 951--953 VI - 62 IP - 10 4099 - http://jcp.bmj.com/content/62/10/951.short 4100 - http://jcp.bmj.com/content/62/10/951.full SO - J Clin Pathol2009 Oct 01; 62 AB - The loss of fluid and electrolytes from a high-output ileostomy (&gt;1200 ml/day) can quickly result in dehydration and if not properly managed may cause acute renal failure. The management of a high-output ileostomy is based upon three principles: correction of electrolyte disturbance and fluid balance, pharmacological reduction of ileostomy output, and treatment of any underlying identifiable cause. There is an increasing body of evidence to suggest that Clostridium difficile may behave pathologically in the small intestine producing a spectrum of enteritis that mirrors the well-recognised colonic disease manifestation. Clinically this can range from high-output ileostomy to fulminant enteritis. This report describes two cases of high-output ileostomy associated with enteric C difficile infection and proposes that the management algorithm of a high-output ileostomy should include exclusion of small bowel C difficile.