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LC Gastroenterology Week 2 > Intestinal Failure > Flashcards

Intestinal Failure Flashcards

1
Q

What is intestinal failure?

A

It results from the inability to maintain adequate nutrition or fluid status via the intestines

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2
Q

How can inststinal failure occur?

A

By obstruction, dysmotility, surgical resection, congenital defect, or diseases associated loss of abdoption

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3
Q

What is intestinal failure characterised by?

A

The inability to maintain protein-energy, fluid, electrolyte or micronutrient balance

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4
Q

Describe simply what intestinal failure is?

A

Where the gut can no longer supply the hydration and nutritional needs of the body

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5
Q

What would acute/short term intestinal failure be classes as (Time wise)?

A

Around 2 weeks

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6
Q

What types of intestinal failure are classed as acute IF?

A

Type 1 and 2

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7
Q

What type of intestinal failure is class as chronic?

A

Type 3

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8
Q

What might be the cause of acute IF?

A

Mucositits post chemotherapy

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9
Q

What might be the cause of chronic IF?

A

Short gut syndrome

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10
Q

What is type 1 IF?

definition

A

Self-limiting short term, postoperative or paralytic ileus

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11
Q

What is type 2 IF?

definition

A

Prolonged, associated with sepsis and metabolic complications. Often related to abdominal surgery with complications

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12
Q

What is type 3 IF?

definition

A

Long term but stable - home parental nutrition often indicated

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13
Q

What is paralytic ileus?

A

Paralytic ileus is the occurrence of intestinal blockage in the absence of an actual physical obstruction. This type of blockage is caused by a malfunction in the nerves and muscles in the intestine that impairs digestive movement.

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14
Q

How would you treat someone with type 1 IF?

A

They are usually normal/moderately malnourished

Replace fluids and correct electrolytes
Paraental nutrition if unable to tolerate oral foods/fluid
PPI ( acid suppression)
Octreoitide
Alpha hydroxycholecalciferol to preserve Mg
Intensive multi-disciplinary input
Allow some diet / enteral feeding

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15
Q

What is parenteral nutrition?

A

Parenteral nutrition (PN) is the feeding of a person intravenously, bypassing the usual process of eating and digestion. The person receives nutritional formulae that contain nutrients such as glucose, salts, amino acids, lipids and added vitamins and dietary minerals.

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16
Q

What might be some complications of parenteral nutrition?

A

Pneumothorax, arterial puncture/misplacement

Sepsis 
SVC thrombosis 
Line leakage/migration/fracture 
Nutrient toxicity/insufficiency 
Liver disease
17
Q

What might be the different ways of venous access devices?

A

Peripherally inserted central catheter

Central venous catheter

  • subclavian vein insertion
  • internal jugular vein insertion
18
Q

Describe what type of patients might have type 2 IF?

A

Septic patents - unwell for weeks, can’t eat and get type 2
Perioperative who may develop a complication of feeding
Usually not until several days after the op

19
Q

How might you treat someone with type 2 IF?

A

Parenteral +/- some enteral feeding

20
Q

Describe the difference between enteral and parenteral feeding?

A

Enteral nutrition generally refers to any method of feeding that uses the gastrointestinal (GI) tract to deliver part or all of a person’s caloric requirements. … Parenteral nutrition refers to the delivery of calories and nutrients into a vein.

21
Q

What is the treatments for type 3 IF?

A

Home parenteral nutrition - treatment of choice

Intestinal transplantation - specific indications

(GLP2 treatment for SBS)
(bowel lengthening - not validated in adults yet)

22
Q

What might be some diseases that lead to type 3 IF and leave you normal/mod malnourished but stable?

A

Crohn’s disease
Short gut syndrome

Neoplasia
Vascular
Mechanical

23
Q

What is neoplasia?

A

The presence or formation of new, abnormal growth of tissue.

24
Q

What is the normal length of the short bowel?

A

Length of the small bowel is between 250-850cm

Males longer than females

25
Q

What is short bowel syndrome classed as and what is its definition?

A

< 200cm of short bowel

Insufficient length of small bowel to meet nutritional needs without artificial nutritional support

26
Q

What disease is the most common indication for HPN?

A

Short bowel syndrome

< 50cm of small bowel

27
Q

Describe a bit about small bowel transplantation?

A

Is it usually the last resort
Usually combined with liver transplant
Stoma but eating

28
Q

What is Mucositis?

A

Mucositis is a condition characterised by pain and inflammation of the body’s mucous membrane.
The mucous membrane is the soft layer of tissue lining the digestive system from the mouth to the anus.

LC Gastroenterology Week 2 (6 decks)

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