A Study to Compare Loperimide to Placebo for the Prevention of Excess Fluid Losses From the Stoma in Patients with New Loop Ileostomy.

INTERVENTION: Loperamide 4mg three times per day orally for 3 months commencing on day of first passage of flatus post‐operatively. Patients will weigh themselves at home daily and keep a diary of stoma output. Empty drug packs will be returned to pharmacy for drug accountability. CONDITION: Acute kidney failure Dehydration High output ileostomy PRIMARY OUTCOME: Incidence of high output ileostomy SECONDARY OUTCOME: Estimated glomerular filtration rate of less than ; 60 ml/min/1.73m2 Mean weight loss after hospital discharge Participant readmission rate Serum creatinine above 110 umol/L Serum sodium below 130 mmol/L or above 145mmol/L Stoma output more than 2 litres per day. Surgical complications, according to the validated Clavien Dindo surgical complication score Total hospital length of stay Weight loss in excess of 10% after discharge INCLUSION CRITERIA: ‐Written informed consent ‐All adult (>18 years) patients undergoing elective or semi‐urgent booked operations involving a loop ileostomy at the participating hospitals. ‐Must have passed flatus post‐operatively, tolerating diet and no signs and symptoms of ileus.