What can exacerbate zinc loss after colectomy with ileostomy?

• A. Decreased protein intake
• B. Vitamin C deficiency
• C. Ileostomy output losses
• D. Increases hydration

Answer: (C)

Zinc is absorbed mainly in the small intestine, but after colectomy with ileostomy the ileum is bypassed for much of the transit, so more intestinal contents—and the zinc they contain—are lost in the ileostomy output. The greater the volume of ileostomy effluent, the more zinc is shed, increasing the risk of zinc deficiency and impaired wound healing. Other factors like protein intake, vitamin C status, or overall hydration can influence zinc status or stool characteristics, but they do not drive the direct, rapid loss of zinc through the ileostomy as strongly as the amount of ileostomy output.