Practical guide to intestinal rehabilitation for postresection intestinal failure: a case study.
After massive small-intestinal resection or combined small-intestinal and colonic resection, diarrhea with resulting dehydration, electrolyte abnormalities, and malnutrition occur. Many patients become dependent on IV fluids and nutrition. An adaptation process manifested clinically by decreased diarrhea and improved nutrient absorption according to decreased parenteral nutrition and fluid requirements has been noted to occur over time. In some patients, adaptation is inadequate and may require special techniques to enhance and augment this process. This is a case of a 52-year-old woman who experienced increased stoma output 1 week after major intestinal resection, resulting in dehydration. She required IV fluids in order to maintain hydration. After the initiation of an intestinal rehabilitation program, which included modified diet, soluble fiber, oral rehydration solution (ORS), and medications, IV fluids were successfully weaned off in 3 months. She continues not to receive IV fluids and continues to follow the intestinal rehabilitation plan.
Matarese
Laura E
LE
Intestinal Rehabilitation and Transplant Center, Thomas E. Starzl Transplantation Institute, UPMC Montefiore, 7 South, 3459 Fifth Avenue, Pittsburgh, PA 15213, USA. mataresele@upmc.edu
Seidner
Douglas L
DL
Steiger
Ezra
E
Fazio
Victor
V
D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D003681:Dehydration / Q000209:etiology / Q000628:therapy; D004032:Diet; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008875:Middle Aged; D044623:Nutrition Therapy; D012778:Short Bowel Syndrome / Q000209:etiology* / Q000628:therapy*