Medicine an Surgery notes

Apr 24th, 2015
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PROBLEMS OF ILEOSTOMIESPhysiologic changes after ileostomy are due to the loss of the water- and salt-absorbing capacity of the colon.If the small bowel is free of disease and extensive resection has not been done, an ileostomy puts out 1-2 L of fluid per day initially. The volume of effluent diminishes to between 500 and 800 mL/d after a month or two. This loss of fluid is obligatory and is not reduced by manipulations of diet. Obligatory sodium losses are about 50 meq/d and potassium losses are also increased. Healthy ileostomy patients have low total exchangeable sodium and potassium but normal serum electrolyte concentrations. The depletion, therefore, is primarily intracellular. The patient with an ileostomy is susceptible to acute or subacute salt and water depletion manifested by fatigue, anorexia, irritability, headache, drowsiness, muscle cramps, and thirst. Patients sho

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