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high ileostomy output

Stephen J Fenning, Steinunn R Boyce, Paul Wilson, Fran Stretton
Hypomagnesaemia can arise from a variety of causes but is particularly prevalent in cancer populations. This case report describes a patient with recurrent symptomatic hypomagnesaemia, on the background of advanced ovarian cancer and a high-output ileostomy, who was successfully managed on a daily continuous subcutaneous infusion of magnesium via a syringe pump. There is limited published information on the subcutaneous administration of magnesium and, to our knowledge, this is the first case to report its routine delivery over 24 hours in a syringe pump...
June 23, 2017: BMJ Supportive & Palliative Care
Katrine Kristensen, Niels Qvist
High stoma output is a common problem in patients with ileostomy and can lead to dehydration and electrolyte disturbances. The first drug of choice to reduce stoma output is often loperamide. The aim was to assess the acute effect of loperamide on (a) ileostomy output in g/day, (b) gastrointestinal transit time and (c) patient-reported effects. A total of 12 patients completed this double-blinded, randomized, placebo-controlled, crossover study, consisting of a 3-day treatment period with loperamide 12 mg/day or placebo followed by the reverse after a washout period of 5-7 days...
June 19, 2017: Basic & Clinical Pharmacology & Toxicology
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
P Ihnát, P Vávra, P Guňková, A Zatloukal, S Czudek, P Zonča
INTRODUCTION: Low anterior resection (LAR) with total mesorectal excision (TME) represents the gold standard for patients with low rectal carcinoma. Protective ileostomy (PI) is commonly performed during LAR in an effort to protect low rectal anastomosis. The aim of this study is to analyse outcomes in our own patient population, focusing on morbidity associated with PI. METHOD: A retrospective clinical study of patients operated on between 2013 and 2015 was conducted in University Hospital Ostrava...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
F J Amelung, C P D Van 't Hullenaar, P M Verheijen, E C J Consten
OBJECTIVE: To investigate whether an ileostomy or colostomy should be preferred in patients requiring temporary double-barrel stoma construction and in whom it is technically possible to construct both types. DESIGN: Systematic literature search and retrospective comparative analysis. METHOD: PubMed, Embase and the Cochrane Library were searched for all literature comparing loop ileostomy and loop colostomy. In addition, we retrospectively analysed 361 patients who had received a loop ileostomy or loop colostomy designed to be temporary between 2009 and 2015 in our hospital, Meander Medisch Centrum, Amersfoort, the Netherlands...
2017: Nederlands Tijdschrift Voor Geneeskunde
Mandana Rastegar, Glenn T Nagami
Acid-base disturbances can result from kidney or nonkidney disorders. We present a case of high-volume ileostomy output causing large bicarbonate losses and resulting in a non-anion gap metabolic acidosis. Non-anion gap metabolic acidosis can present as a form of either acute or chronic metabolic acidosis. A complete clinical history and physical examination are critical initial steps to begin the evaluation process, followed by measuring serum electrolytes with a focus on potassium level, blood gas, urine pH, and either direct or indirect urine ammonium concentration...
February 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ann Goodey, Sharon Colman
An ileostomy is where the small bowel is diverted to the abdominal surface resulting in the formation of a stoma. An Ileostomy can be temporary or permanent and produces loose faeces. Some ileostomates can develop high output in the early postoperative stage. Most will resolve, some will require ongoing treatment and management. While patients are monitored closely according to protocol in hospital once discharged into the community, there appears to be little standardisation. A literature search revealed that existing guidelines are for management of patients in the acute care setting...
December 8, 2016: British Journal of Nursing: BJN
George Melich, Ajit Pai, Banujan Balachandran, Slawomir J Marecik, Leela M Prasad, John J Park
INTRODUCTION: Large high-output enterocutaneous fistulas pose great difficulties, especially in the setting of recent surgery and compromised skin integrity. METHODS: This video demonstrates a new technique of endoscopic control of enterocutaneous fistula by using two covered overlapping stents. In brief, the two stents are each inserted endoscopically, one proximal, and the other distal to the fistula with 2 cm of each stent protruding cutaneously. Following this, the proximal stent is crimped and intussuscepted into the distal stent with an adequate overlap...
September 2016: Surgical Endoscopy
Kathryn Lynes, Daniel A Lawes, Charles M Bailey
INTRODUCTION: Restorative proctocolectomy (RPC) with ileal-pouch anal anastomosis (IPAA) is a technically challenging procedure. This study aims to review the outcomes following surgery carried out in a DGH by two surgeons with experience gained in tertiary centres. MATERIALS AND METHODS: All patients undergoing RPC with IPAA were identified from a prospectively collected database and case notes reviewed. Data were collected on demographics, indication for surgery, operative details, outcomes and adherence to a treatment and follow-up protocol developed with a specialist centre...
April 2016: International Journal of Surgery
Scott Mitchell Wright, Muhammad Jawad Noon, William Bates Greenough
A 27-year-old patient with spina bifida and a high output loss of water and electrolytes from her ileostomy was successfully liberated from dependency on total parenteral nutrition and intravenous fluid and electrolyte replacement by the use of a rice-based oral rehydration therapy (ORT). This allowed her to return home to the care of her mother. We suggest that ORT can be effective in the context of modern high-technology settings, as well as in resource-poor situations.
February 2016: Journal of General Internal Medicine
Jose J Arenas Villafranca, Cristobal López-Rodríguez, Jimena Abilés, Robin Rivera, Norberto Gándara Adán, Pilar Utrilla Navarro
INTRODUCTION: An issue of recent research interest is excessive stoma output and its relation to electrolyte abnormalities. Some studies have identified this as a precursor of dehydration and renal dysfunction. A prospective study was performed of the complications associated with high-output stomas, to identify their causes, consequences and management. MATERIALS AND METHODS: This study was carried out by a multidisciplinary team of surgeons, gastroenterologists, nutritionists and hospital pharmacists...
May 9, 2015: Nutrition Journal
Alicia Mackowski, Han-Kuang Chen, Michael Levitt
High-stoma output is a common problem that can lead to dehydration and electrolyte disturbance. The following report describes three patients with end ileostomy who had high-stoma outputs where conventional medical management was unsuccessful in controlling stoma output. All three patients responded to high-dose loperamide, resulting in significant clinical improvement. High-dose loperamide therapy should be considered in patients with high-stoma output who have failed conventional medical management.
April 22, 2015: BMJ Case Reports
Ker Kan Tan, Ragavan Manoharan, Saissan Rajendran, Praveen Ravindran, Christopher J Young
INTRODUCTION: The aim of the study was to determine if age at the creation of an ileal pouchanal anastomosis (IPAA) has an impact on the outcomes in patients with ulcerative colitis (UC). MATERIALS AND METHODS: A retrospective review of all patients who underwent IPAA for UC from 1999 to 2011 was performed. Long-term functional outcome was assessed using both the Cleveland Clinic and St Mark's incontinence scores. RESULTS: Eighty-nine patients, with a median age of 46 (range, 16 to 71) years, formed the study group...
March 2015: Annals of the Academy of Medicine, Singapore
D Söhngen, C Balzer, M Fuchs, D Waldschmidt
BACKGROUND: Patients with ileostomies regularly suffer from short bowel syndrome or high volume output associated with loss of absorptive surface and subsequent impairment of absorption for drugs and different nutrients resulting in electrolyte and fluid balance disorders as well as renal insufficiency. Adaptation of these fundamental functions of the gut with adequate fluid uptake, absorption of sufficient different nutrients and vitamins represents a major challenge to rehabilitate these patients shortly after surgery...
April 2015: Die Rehabilitation
(no author information available yet)
No abstract text is available yet for this article.
February 2015: Journal of Crohn's & Colitis
Kamran Rostami, David Al Dulaimi
Elemental diet (ED) has been used widely in the treatment of gastrointestinal disorders, especially with the management of Crohn's disease. This modality of diets provides all essential nutrients, and contains protein in the form of free amino acids that are theoretically easily absorbed. High output ileostomies are a rare but important complications of stoma formation following bowel surgery. Treatments could be challenging and include anti-diarrhoeals, octreotide and proton pump inhibitors. There is very little research regarding the use of elemental diets in the treatment of patients with post-operative high ileostomy outputs...
2015: Gastroenterology and Hepatology From Bed to Bench
Carla Margiani, Luigi Zorcolo, Paolo Mura, Marcello Saba, Angelo Restivo, Francesco Scintu
INTRODUCTION: Lactic acidosis is a well-known complication of the anti-hyperglycemic biguanide agent metformin, especially in peculiar but not rare clinical conditions. Attempts to reduce the incidence of this adverse reaction have been enforced by national agencies over the years. The Italian Medicines Agency recently released a safety recommendation on prescribing the drug and with regard to the existence of several conditions that contraindicate drug continuation, such as dehydration, infection, hypotension, surgery or hyperosmolar contrast agent infusion, but the recommendation does not mention the increased risk related to stoma...
2014: Journal of Medical Case Reports
Jose Javier Arenas Villafranca, Jimena Abilés, Gloria Moreno, Begoña Tortajada Goitia, Pilar Utrilla Navarro, Norberto Gándara Adán
High output stoma is a frequent complication in patients with ileostomies that is not well identified and is not often properly addressed by clinicians. It has not been described properly, and can vary between debits of 2.000ml in 24 h to 1.500 ml in 3-5 days, according to different authors. Frequently presents both short-term and long-term negative implications for patients and is associated with readmissions. We present a review of published literature focusing in surgical resection-related factors that influence a later appearance of this complication, causes involved in its development, the need to establish a clear and objective concept of high ouput as well as the negative implications it presents...
December 1, 2014: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Alison Crawshaw, Julia Williams, Fran Woodhouse
The psychological impact stoma surgery can have on an individual is well documented within the literature (White and Hunt, 1997; Borwell, 2009; Williams, 2005; Brown, 2005). For many years, surgeons have explored and developed innovations in surgical techniques, in particular restorative procedures with a view of preventing permanent stoma formation; ileal anal pouch (IAP) now being the surgical procedure of choice for treatment of ulcerative colitis (UC) and familial adenomatous polyposis (FAP). However, high morbidity rates are associated with pouch longevity (Castillo et al 2005; Nessar and Wu, 2012) and once removed can lead to a high-output ileostomy with risks of electrolyte imbalance and malabsorption...
September 25, 2014: British Journal of Nursing: BJN
Michelle A Glasgow, Kristin Shields, Rachel Isaksson Vogel, Deanna Teoh, Peter A Argenta
OBJECTIVES: Ileostomy results in a relatively poorer water reabsorption and is associated with dehydration and renal injury. These problems may be exacerbated in the setting of gynecologic cancers owing to both patient and disease-related factors. We evaluated the rate and reasons for hospital readmission within 30 days of ileostomy creation in patients with a gynecologic malignancy. METHODS: We performed a retrospective review of women with gynecologic malignancies who underwent ileostomy creation between 2002 and 2013...
September 2014: Gynecologic Oncology
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