Drug therapy and nutritional management of patients with gastrointestinal fistulas

Dombrowski, Susan R.; Mirtallo, Jay M.

doi:10.1093/ajhp/41.7.1438

Cited by 2 publications

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“…Gastric volume secretion is minimized by gastric acid inhibition with proton pump inhibitors, which also has a small effect in reducing electrolyte loss. 24 Both lansoprazole and omeprazole significantly decrease basal and pentagastrin-induced acid secretion 25 with a dose-dependent response 26 ; twice-daily regimes are more effective than once-daily ones. 27…”

Section: Stabilization Fluid Lossesmentioning

confidence: 99%

High-Output Fistula

Arebi

Forbes²

2004

Clinics in Colon and Rectal Surgery

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Despite improvements in healthcare delivery, mortality rates for high-output fistulae remain unchanged. The pathophysiology and causes of fistulae are reviewed in this article. An overview of the diagnostic procedures to delineate fistulae and underlying bowel disease together with their complications is included. Management of high-output fistulae consists of assessment and stabilization of patients, followed by conservative management by a multidisciplinary team until spontaneous or surgical closure of fistulae.

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Section: Stabilization Fluid Lossesmentioning

confidence: 99%

High-Output Fistula

Arebi

Forbes²

2004

Clinics in Colon and Rectal Surgery

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“…Other, rarer conditions of interest are liver failure following jejunoileal bypass, and anorexia nervosa. Gastrointestinal fistulae 38 Prior to the introduction of TPN, the mortality of small bowel fistulae was in excess of 50%. Maintenance of good nutrition has reduced that figure to 10-20070 in different series.…”

Section: Total Parenteral Nutrition In Gastrointestinal Diseasementioning

confidence: 99%

Total Parenteral Nutrition in Acute Illness

Phillips

1985

Anaesth Intensive Care

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Successful total parenteral nutrition in acute illness requires an appreciation of the pathophysiology of the illness and an understanding of the nutritional state of the patient, as well as a knowledge of the principles of total parenteral nutrition. Management of the acutely ill patient's general condition is essential prior to the introduction of nutritional support. A basic regimen which includes administration of 1-2g/kg/day of protein, and 8,400 kJ (2,000 kcal)/day of energy, part glucose and part lipid, together with all minerals, vitamins and zinc, in an appropriate amount of water, should be provided. Modifications to this regimen may be indicated to accommodate cardiac, respiratory, liver or renal failure. The questions of the optimum mix of carbohydrate and lipid, the ideal amount of protein and the correct mix of amino acids for a particular period in an individual patient's illness, are still debated. The fact that recent research supports many of the postulates of the Scandinavian pioneers of total parenteral nutrition suggests we may be returning to a correct approach.

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Drug therapy and nutritional management of patients with gastrointestinal fistulas

Cited by 2 publications

References 0 publications

High-Output Fistula

High-Output Fistula

Total Parenteral Nutrition in Acute Illness

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