36 1.2 IF Flashcards

Cards
 Quiz

Matching

UPDATED
Bingo

Print Print
Set Details Share
created 3 weeks ago by Rereih
updated 3 weeks ago by Rereih
show moreless
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:

1

how much nutrients lost in feces (%)

5%

2

IF definition

The reduction of gut function below the minimum necessary for the absorption of macronutrients and/or fluids and electrolytes that interavenous support is required to maintain health and growth

3

Intestinal insuffiency

the reduction in the absorptive function of the gut that does not require intravenous supplementation to maintain heath or growth

4

(true or false) patients receiving IV nutrition means intestinal failure

false

patients receiving IV nutrition not necessarily intestinal failure

5

Functional or chronological classification of IF

Type 1 (self-limiting, short-term) (inflammation, post operative ileus)

Type 2 (prolonged) (GI complications, abdominal sepsis, enterocutaneous fistula)

Type 3 (chronic) (volvous, NEC, SBS, crohns)

6

Pathological Classification of IF

  1. SBS (most common cause)
  2. Intestinal dysmotility (second most common)
  3. Enterocutaneous fistula
  4. Mechanical occlusion
  5. Extensive small bowel mucosal disease

7

Normal length of small bowel (adults and pediatrics)

Cutoff for SBS

Pediatrics ~ 2 m

Adults ~ 2.75-8 m

<200cm

8

Genetic Predisposition to Crohn's Disease

– Concordance rates: MZ twin 30%; DZ twins 4%

– NOD2, IL23

9

SBS types

  1. Type 1: End jejunostomy/ileotomy
  2. Type 2: Jejuno-colonic anastomosis
  3. type 3: Jejuno-ileal-colonic anastomosis

10

Mucus fistula refeeding

Reinfuses proximal stoma effluent into the distal bowel to enhance nutrient absorption, promote bowel adaptation, and reduce dependence on parenteral nutrition.

  • Used in babies with extensive bowel resection and stoma
  • Randomised controlled trial underway in neonates
  • Messy, difficult, controversial, complications
  • Some experience in adults but no RCTs

11

Intestinal dysmotility main cause

Chronic Intestinal Pseudo-Obstruction (CIPO)

  • dysmotile bowel (neuropathic, myopathic)
  • Symptoms (nausea, vomiting, abdominal pain, SBO)

12

St. Mark's solution contents

  • 1 Liter water
  • 20 g Glucose
  • 2.5g Sodium bicarbonate
  • 3.5g Sodium chloride

13

Pharmacological treatment of IF

1. Anti-motility Drugs (Codeine Phosphate, Loperamide)

- increase transit time and absorption

2. Anti-secretory Drugs (Proton Pump Inhibitors, Octreotide)

- reduce diarrhoea

3. Teduglutide (Glucagon-Like Peptide-2 analogue)

- improve intestinal adaptation