ABSTRACT
A 5-month-old patient with a diagnosis of total colonic Hirschsprung disease (TCHD) and an ileostomy in place presents to your outpatient clinic. He is having high liquid ileostomy output, 50 mg/kg/day. His mother reports that he is eating formula normally but he is not gaining weight well. There is no history of abdominal distension or pain or any other signs of enterocolitis. He is on the 10th percentile for weight.
