An 87-year-old woman with ileostomy output of 1.5-2.0 liters per day after colectomy; supplementation of which micronutrient should be considered?

• A. Copper
• B. Vitamin D
• C. Zinc
• D. Chromium

Answer: (C)

High ileostomy output means large ongoing losses of minerals through the stoma. Zinc is one of the trace minerals most affected by these enteric losses, because it is present in GI secretions and absorbed mainly in the small intestine. When daily ostomy output is substantial, zinc can become depleted, leading to problems such as impaired wound healing, skin breakdown, immune dysfunction, and poor appetite. Supplementing zinc helps replace these losses and supports recovery and overall function in this situation. While vitamin D, copper, and chromium are important in various contexts, zinc deficiency is the most likely and most clinically relevant risk with high ileostomy output, making zinc the appropriate supplementation choice. If zinc is given, monitoring for copper status is reasonable, since excess zinc can interfere with copper absorption.