short bowel syndrome & stoma care

Question 1

SBS imp points

Answer 1

shortened bowel due to large surgical resection

need to ensure adequate absorption of nutrients and fluid

vitamin deficiency - replace in vit A, B12, D, E, K, fatty acids, zinc, selenium

if diarrheoa or high output in stoma - loperamide or codeine to reduce intestinal motility

Question 2

what is a stoma

Answer 2

artificial opening in abdomen to divert flow of faeces or urine into an external pouch

Question 3

stoma care points

Answer 3

enteric coated/modified release caps - not suitable - insufficient effect from drug
- use forms with quick action

sorbitol, magnesium antacids, iron (ileostomy) - can cause diarrhoea

opioids, calcium antacids, iron (colostomy) - can cause constipation

aspirin + NSAIDs - GI irritation/bleeds

diuretics/laxatives - dehydration - hypokalaemia - use K+ sparing diuretics or potassium supplements
- use liquid form potassium - not MR forms
- hypokalaemia can also increase risk of digoxin toxicity