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nutritional\tsupport\tduring\tthe\tinitial\tworkup\tphase.\n\tPN,\tEN,\toral\tdiet,\tor\ta\tcombination\tis\tused\tin\npatients\twith\tECF.\tThe\tdecision\tregarding\twhich\troute\tto\tfeed\tpatients\twith\tECF\tdepends\ton\tseveral\nfactors,\tincluding\tthe\torigin\tof\tthe\tfistula,\tthe\tpresence\tof\tobstructions\t... | [
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functional\tbowel,\tthe\tlikelihood\tof\tfistula\tclosure,\tthe\tability\tto\tmanage\tfistula\toutput,\tand\tthe\npatient’s\toverall\tmedical\tcondition\t(see\t\nChapter\t12\n).\nIntestinal\tostomies\nThe\tword\t\nostomy\n,\tderived\tfrom\tthe\tLatin\tword\t\nostium\n,\trefers\tto\tmouth\tor\topening.\tAn\t\nintestinal... | [
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ostium\n,\trefers\tto\tmouth\tor\topening.\tAn\t\nintestinal\nostomy\n\tis\ta\tsurgically\tcreated\topening\tbetween\tthe\tintestinal\ttract\tand\tthe\tskin\tand\tis\tspecifically\nnamed\taccording\tto\tthe\tsite\tof\torigin\talong\tthe\tintestinal\ttract.\tAbout\t100,000\tpeople\tin\tthe\tUnited\nStates\tundergo\toper... | [
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(\nSheetz\tet\tal,\t2014\n).\tThe\nhigh\tincidence\tof\tostomy\tis\tdue\tin\tpart\tto\tthe\tincreasing\tprevalence\tof\tCRC\tand\tdiverticular\nsurgeries\tin\tthe\tUnited\tStates.\tOstomies\tare\tcreated\tfor\tmany\treasons;\t\nTable\t27.7\n\tlists\tindications\nfor\tthe\tcreation\tof\tostomies.\nTABLE\t27.7\nPotential... | [
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Ileostomy\nColostomy\nCrohn’s\tdisease\nUlcerative\tcolitis\nFAP\nColon\tcancer\nRectal\tcancer\nBowel\tperforation\nBowel\tischemia\nRectal\ttrauma\nFecal\tincontinence\nFecal\tdiversion\nColonic\tdysmotility\nToxic\tcolitis\nAnastomotic\tleak\nDistal\tobstruction\nEnterocutaneous\tfistula\nColon\tcancer\nRectal\tcanc... | [
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Rectal\tcancer\nDiverticulitis\nRectal\ttrauma\nRadiation\tproctitis\nDistal\tobstruction\nFecal\tincontinence\nComplex\tfistula\nFAP,\n\tFamilial\tadenomatous\tpolyposis.\nColostomies\tand\n\tileostomies\tcan\tbe\tcategorized\tas\teither\tloop\tor\tend\tostomies.\tA\t\nloop\tostomy\n\tis\nformed\twhen\ta\tloop\tof\tbo... | [
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distal\tend\tis\tsutured\tto\tthe\tskin,\twhereas\tthe\tproximal\tside\tof\tthe\tloop\tis\teverted\tback\ton\titself\n(\nMartin\tand\tVogel,\t2012\n).\tThe\tresult\tis\ta\tstoma\twith\ttwo\topenings:\tthe\tproximal\t(functional)\tlimb\nfrom\twhich\tthe\teffluent\n\tor\tstool\tis\tdischarged,\tand\tthe\tdistal\tlimb,\tw... | [
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and\tsecrete\tmucus.\tA\tloop\tostomy\tis\tused\tmost\toften\twhen\ta\ttemporary\tostomy\tis\tformed.\tAn\t\nend\nostomy\n\tis\tcreated\twhen\tthe\tbowel\tis\tcut\tand\tthe\tend\tis\tbrought\tthrough\tthe\tskin\tto\tcreate\tthe\nstoma.\tEnd\tand\tloop\tostomies\tare\tpotentially\treversible.\tThe\toutput\tfrom\tan\tile... | [
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effluent,\twhereas\toutput\tfrom\ta\tcolostomy\n\tis\tstool.\nColostomy\nA\t\ncolostomy\n\tis\ta\tsurgically\tcreated\topening\tfrom\tthe\tcolon\tto\tthe\tskin\twhen\ta\tportion\tof\tthe\tlarge\nintestine\tis\tremoved\tor\tbypassed\t(\nFig.\t27.6\n).\tIt\tcan\toriginate\tfrom\tany\tpart\tof\tthe\tcolon:\tascending, | [
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Fig.\t27.6\n).\tIt\tcan\toriginate\tfrom\tany\tpart\tof\tthe\tcolon:\tascending,\ntransverse,\tdescending,\tor\tsigmoid.\tIt\ttypically\tstarts\tfunctioning\t2\tto\t5\tdays\tafter\tsurgery\tand\tthe\namount\tand\ttype\tof\toutput\tvaries\tslightly,\tdepending\ton\tthe\tamount\tof\n\tremaining\tcolon.\tStool\tfrom\ta | [
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remaining\tcolon.\tStool\tfrom\ta\ncolostomy\ton\tthe\tleft\tside\tof\tthe\tcolon\tis\tfirmer\tthan\tthat\tfrom\ta\tcolostomy\ton\tthe\tright\tside,\twith\nstool\toutput\tranging\tfrom\t200\tto\t600\tmL/day.\tPatients\twith\tsigmoid\tcolostomies\thave\telimination\npatterns\tsimilar\tto\ttheir\tpreoperative\tstates,\tu... | [
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FIG.\t27.6\nColostomy.\n\t\nSource:\n\t(Cleveland\tClinic,\tCleveland,\tOhio,\tUSA.)\nIleostomy\nAn\t\nileostomy\n\tis\ta\tsurgically\tcreated\topening\tfrom\tthe\tdistal\tsmall\tbowel\t(most\toften\tthe\tterminal\nileum)\tto\tthe\tskin\twhen\tthe\tentire\tcolon,\trectum,\tand\tanus\tare\tremoved\tor\tbypassed\t(\nFig.... | [
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Fig.\t27.7\n).\nTypically,\ta\tnew\tileostomy\twill\tstart\tfunctioning\twithin\t24\thours\tafter\tsurgery,\tand\tthe\teffluent\tis\ninitially\tbilious\n\tin\tcolor\tand\twatery\t(\nWillcutts\tand\tTouger-Decker,\t2013\n).\tStoma\toutput\tincreases\ninitially\tto\tabout\t1200\tmL\tper\t24\thours\tfor\tthe\tfirst\t1\tto... | [
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to\t3\tmonths,\tthe\teffluent\tthickens\t(semiliquid\tto\tporridge-like\tconsistency)\tand\toutput\tdrops\tto\tless\nthan\ta\tliter\tper\tday.\nFIG.\t27.7\nIleostomy.\n\t\nSource:\n\t(Cleveland\tClinic,\tCleveland,\tOhio,\tUSA.)\nMedical\tmanagement | [
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Management\tof\ta\tnew\tostomy\tpatient\tinvolves\tmaintenance\tof\tnutritional\tand\thydration\tstatus,\nmeticulous\tskin\tcare,\tand\tadequate\tcontainment\tof\tthe\tfecal\tstream\tusing\ta\tpouching\tsystem\tin\tthe\nhospital\tand\tas\tthe\tpatient\ttransitions\tto\thome\t(\nMcDonough,\t2013\n).\tIt\tis\tvery\thelpf... | [
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McDonough,\t2013\n).\tIt\tis\tvery\thelpful\twhen\ta\tpatient\nis\tevaluated\n\tby\tan\tenterostomal\ttherapist\t(a\tnurse\twho\tspecializes\tin\tthe\tcare\tof\tstomas)\tbefore\nsurgery\tto\tmark\tthe\tmost\tappropriate\tsite\tfor\tan\tostomy.\tThis\tminimizes\tpotential\tskin\tand\tpouch\nsystem\tproblems.\tA\tpoorly\... | [
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application\tand\tmay\tsignificantly\taffect\tpatient\tquality\tof\tlife\t(QoL).\tA\twell-functioning\tostomy\tis\nassociated\twith\n\ta\tsuperior\tQoL.\tIn\tthose\tpatients\twho\texpress\tconcerns\tregarding\tsuboptimal\tQoL,\nsocial\trestrictions,\tpsychosexual\tissues,\tand\tfear\tof\tthe\tostomy\tappliance\tleaking... | [
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major\tlimiting\tfactors\t(\nCharua-Guindic\tet\tal,\t2011\n).\nMedical\tnutrition\ttherapy\nTraditional\trecommendations\tfor\tpostoperative\tfeeding\tof\tpatients\twith\teither\ta\tcolostomy\tor\nileostomy\twas\tto\thold\tfeeding\tuntil\tthe\tbowel\n\tstarted\tto\t“function”\tor\tput\tout\tstool\tor\teffluent. | [
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started\tto\t“function”\tor\tput\tout\tstool\tor\teffluent.\nHowever,\tthere\tis\tevidence\tthat\tan\toral\tdiet\tor\ttube\tfeeding\tcan\tstart\tearly\tafter\tsurgery\tfor\tany\ttype\nof\tfecal\tdiversion\tstoma\tthat\twas\tcreated\tduring\tan\telective\tsurgery.\tThe\tAND\tand\tthe\tUnited\nOstomy\tAssociations\tof\tA... | [
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surgery\t(\nAND,\t2014\n;\t\nUnited\tOstomy\tAssociations\tof\tAmerica,\t2011\n).\tThis\tadvice\tis\tbased\ton\tthe\npremise\tthat\tthe\tbowel\tis\tedematous\tand\ttherefore\tat\trisk\tfor\tbeing\tdamaged\tand\tor\tbecoming\nobstructed\tafter\tsurgery.\tMost\tpatients\ttransition\tto\ta\tnormal\tdiet\twith\ta\tgradual\... | [
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fiber\tintake\tafter\t6\tweeks.\nVitamin\tB\n12\n\tand\tbile\tsalts\tor\tfat\tmalabsorption\tare\tnormally\tnot\ta\tconcern\twith\ta\tdistal\tileostomy.\nGreater\tthan\t100\tcm\tof\tileum\tmust\tbe\tresected\n\tbefore\tsteatorrhea\tor\tfat-soluble\tvitamin\tdeficiency\noccurs,\tand\tgreater\tthan\t60\tcm\tmust\tbe\tres... | [
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12\n\tabsorption\tis\tcompromised\n(\nParrish\tand\tDiBaise,\t2014\n).\nControlling\tflatus\tand\todor\tis\ta\tcommon\tconcern\tfor\tthe\tcolostomy\tpatient\trather\tthan\tfor\ta\tpatient\nwith\tan\tileostomy.\tMany\tpatients\telect\tto\tlimit\tfoods\tthat\thave\tthe\tpotential\tto\tincrease\tflatus\tor\ncause\tincreas... | [
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cause\tincreased\todor\n\tof\tstool\toutput.\tA\tpatient\tmust\texperiment\twith\thow\tdifferent\tfoods\taffect\noutput.\tDeodorants\tare\tavailable,\tand\tostomy\tappliances\tare\tmade\twith\todor-barrier\tmaterial\tand\ncan\tinclude\tcharcoal\tfilters\tthat\tvent\tand\tdeodorize\tgas.\nAnother\tconcern\tfor\tan\tileo... | [
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stoma\tsite\tresulting\tfrom\tnarrowing\tof\tthe\tintestinal\tlumen\tat\tthe\tpoint\n\twhere\tthe\tileum\tis\tbrought\nthrough\tthe\tabdominal\twall.\tPatients\tare\tinstructed\tto\tchew\ttheir\tfood\tvery\twell\tto\treduce\tthe\nchance\tof\tblockage.\tIleostomy\tpatients\twith\thigher\tvolumes\tof\twatery\teffluent\ta... | [
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incorporate\tthickening\tfoods\tto\thelp\tthicken\tstoma\toutput.\tThe\tpatient\tmay\thave\tto\texperiment\nbecause\tthickened\toutput\tmay\tbe\tdesirable\tat\ttimes\tbut\tcan\tcause\tdiscomfort\tif\toutput\n\tis\tthickened\ntoo\tmuch.\tRefer\tto\t\nTable\t27.8\n\tfor\tthe\teffects\tof\tvarious\tfoods\ton\tostomy\toutp... | [
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0.05687141790986061,
0.02009... |
TABLE\t27.8\nFoods\tThat\tAffect\tOstomy\tOutput\nGas-Forming\tFoods\nOdor-Producing\tFoods\nFoods\tThat\tMay\tControl\tOdor\nBroccoli\nBrussels\tsprouts\nCabbage\nCauliflower\nGarlic\nOnions\nFish\nEggs\nCarbonated\tbeverages\nAlcoholic\tbeverages\nDairy\tproducts\nLegumes\t(dried\tbeans)\nChewing\tgum\nAsparagus\nBea... | [
-0.004092940595000982,
-0.057671334594488144,
0.014741399325430393,
0.02585141733288765,
-0.03439059853553772,
0.04176326096057892,
0.010907670482993126,
-0.016764605417847633,
-0.024334130808711052,
0.04141774773597717,
0.14291803538799286,
-0.10397184640169144,
-0.0017820262582972646,
-0... |
Broccoli\nBrussels\tsprouts\nCabbage\nCauliflower\nGarlic\nOnions\nFish\nEggs\nSome\tvitamins\nStrong\tcheese\nButtermilk\nCranberry\tjuice\nOrange\tjuice\nYogurt\nParsley\nSpinach\nTomato\tjuice\nFoods\tThat\tMay\tThicken\nStool\nFoods\tThat\tMay\tCause\nObstruction\nFoods\tThat\tMay\tCause\tDiarrhea\nPasta\nWhite\tbr... | [
-0.011897796764969826,
-0.07828491181135178,
-0.0006723047699779272,
0.015789471566677094,
-0.030218062922358513,
0.0174050685018301,
0.014401494525372982,
0.0002735920425038785,
-0.04133513942360878,
0.03706357628107071,
0.15625621378421783,
-0.06794897466897964,
0.025264129042625427,
-0.... |
White\tbread\nWhite\trice\nPotatoes\nCheese\nPretzels\nCreamy\tpeanut\tbutter\nApplesauce\nBanana\nMarshmallow\nTapioca\nApple\tpeel\nOrange\nPineapple\nGrapes\nDried\tfruits\nRaw\tcabbage\nRaw\tcelery\nChinese\tvegetables\nCorn\nMushrooms\nCoconut\nPopcorn\nNuts\nAlcoholic\tbeverages\nCaffeinated\tfluids\nChocolate\nW... | [
0.0037088904064148664,
-0.01692633517086506,
0.012195853516459465,
0.055772390216588974,
-0.034613024443387985,
0.034188348799943924,
0.04801768809556961,
0.013304024934768677,
-0.03746780380606651,
0.022090615704655647,
0.09474174678325653,
-0.08924637734889984,
0.024462681263685226,
0.01... |
Whole\tgrains\nBran\tcereals\nFresh\tfruits\nGrape\tjuice\nPrune\tjuice\nRaw\tvegetables\nSpicy\tfoods\nFried\tfoods\nHigh-fat\tfoods\nFoods\thigh\tin\trefined\tsugar\tor\nsorbitol\nData\tfrom\tAcademy\n\tof\tNutrition\tand\tDietetics:\t\nNutrition\tCare\tManual,\tIleostomy\n\t(website):\t\nhttp://nutritioncaremanual.o... | [
-0.024542536586523056,
-0.02987239696085453,
0.005097921006381512,
0.021448900923132896,
-0.038625072687864304,
-0.01159768644720316,
0.031929612159729004,
0.035398807376623154,
-0.04557960480451584,
-0.007373976521193981,
0.12835568189620972,
-0.026860332116484642,
0.028781995177268982,
-... |
(website):\t\nhttp://nutritioncaremanual.org/\n,\t2018.\tMcDonough\tMR:\tA\ndietitian’s\tguide\tto\tcolostomies\tand\tileostomies,\t\nSupport\tLine\n\t35(3):3,\t2013;\tUnited\tOstomy\tAssociations\tof\tAmerica:\tDiet\tand\tNutrition\tGuide\n(website):\t\nhttp://www.ostomy.org/ostomy_info/pubs/OstomyNutritionGuide.pdf | [
0.009611147455871105,
-0.05703331530094147,
0.011419025249779224,
0.05173094943165779,
-0.14671947062015533,
0.010183756239712238,
-0.04004746302962303,
0.004027758724987507,
-0.08350496739149094,
0.021130742505192757,
0.06554977595806122,
-0.03466856852173805,
-0.10357163846492767,
-0.044... |
http://www.ostomy.org/ostomy_info/pubs/OstomyNutritionGuide.pdf\n,\t2011;\tWillcutts\tK\tet\tal:\tOstomies\tand\tfistulas:\ta\tcollaborative\napproach,\t\nPract\tGastroenterol\n\t29:63,\t2005.\nMaintenance\tof\tadequate\tfluid\tand\telectrolyte\tstatus\tis\tan\timportant\tnutrition-related\tissue\tin | [
0.017276499420404434,
-0.05228028446435928,
0.03135722875595093,
-0.003976826556026936,
-0.0985814705491066,
-0.02519863098859787,
0.02591812051832676,
0.05818004906177521,
-0.01272811833769083,
0.07011684775352478,
0.07404584437608719,
0.011936322785913944,
-0.01721302419900894,
0.0454978... |
managing\ta\tpatient\twith\tcolostomy\tor\tileostomy.\tPatients\twith\tan\tileostomy\tmust\trecognize\tthe\nsymptoms\tof\tdehydration\tand\tunderstand\tthe\timportance\tof\tmaintaining\tadequate\tfluid\tintake\nthroughout\tthe\tday.\tIn\taddition,\tpatients\tmay\thave\tto\tincrease\ttheir\n\tsalt,\tpotassium,\tand\tmag... | [
0.014508373104035854,
-0.0017231970559805632,
0.07425779849290848,
-0.025282641872763634,
-0.1212577372789383,
-0.017155911773443222,
0.07688191533088684,
-0.0031293737702071667,
-0.02341538667678833,
0.036276038736104965,
0.09612954407930374,
0.027062542736530304,
0.02654200978577137,
0.0... |
intake\tresulting\tfrom\tlosses\tin\tileostomy\toutput.\nOstomy\toutput\tmay\tbecome\tacutely\tor\tchronically\televated,\tand\tthis\tis\tmuch\tmore\tcommon\twith\nan\tileostomy.\tThe\tgenerally\taccepted\tdefinition\tof\ta\t\nhigh-output\tstoma\t(HOS)\n\tis\toutput\tthat\nexceeds\t2000\tmL/day\tover\t3\tconsecutive\td... | [
-0.01705940067768097,
-0.007181528955698013,
0.08079389482736588,
-0.02995571680366993,
-0.08995114266872406,
-0.02915921062231064,
0.070558562874794,
-0.03570788353681564,
-0.03160088136792183,
0.03498928248882294,
0.08459533751010895,
-0.03839048743247986,
0.05236782133579254,
-0.0145951... |
depletion\tare\texpected\t(\nBaker\tet\tal,\t2011\n).\tThere\tare\tmultiple\tpotential\tcauses\tof\tHOS,\tincluding\nIBD,\t\nClostridium\tdifficile\n,\tintraabdominal\tsepsis,\tpartial\tor\tintermittent\tobstruction,\tmedication-\nrelated\tcauses,\tdrinking\ttoo\tmuch\tfluid\t(especially\thypertonic/hyperosmotic\tfluid... | [
-0.04813123121857643,
-0.025566618889570236,
0.0661279484629631,
-0.04925385117530823,
-0.05097879469394684,
-0.014182633720338345,
0.07777058333158493,
0.07714517414569855,
0.040713150054216385,
0.04016197472810745,
0.06142269819974899,
-0.020168017596006393,
0.02952606976032257,
0.027231... |
results\tin\tless\tthan\t200\tcm\tof\tresidual\tsmall\tbowel\tand\tno\tcolon\t(\nParrish\tand\tDiBaise,\t2014\n).\nManagement\tof\tHOS\tincludes\tassessment\tand\tcorrection\n\tof\tdepleted\telectrolytes\tand\tminerals;\ninitiation\tof\tan\tORS\tsipped\tthroughout\tthe\tday;\tavoidance\tof\thypertonic,\tsimple\tsugar–c... | [
-0.008286076597869396,
0.009463435038924217,
0.042836546897888184,
-0.03016330674290657,
-0.08571577817201614,
0.006320494692772627,
0.09919876605272293,
-0.009602030739188194,
0.008714213967323303,
0.08550062030553818,
0.10524283349514008,
-0.044753558933734894,
0.07078301906585693,
0.032... |
liquids\tand\tfoods;\trestriction\tof\tfoods\thigh\tin\tinsoluble\tfiber;\tseparation\tof\tsolids\tand\tliquids\tat\nmeals;\tand\tconsumption\tof\tsmaller\tmeals,\tmore\toften\t(up\tto\tsix\tto\teight\tper\tday)\t(\nMcDonough,\t2013\n;\nParrish\tand\tDiBaise,\t2014\n).\tMalnutrition\tcan\toccur\tin\tcases\n\tof\tpersis... | [
0.0017364186933264136,
-0.058576248586177826,
0.059579722583293915,
-0.004250672645866871,
-0.036647893488407135,
0.012049042619764805,
0.11465978622436523,
0.006811188999563456,
-0.008701493963599205,
0.002779982052743435,
0.1093059554696083,
-0.046650759875774384,
0.03812120854854584,
0.... |
of\tpersistent\tHOS,\tand\tmany\tpatients\nmust\tincrease\ttheir\tintake\tto\tmaintain\ttheir\tnutritional\tstatus.\tMeeting\tthe\tincreased\tnutritional\ndemand\tmay\tnot\tbe\tpossible\tvia\toral\tmeans\tfor\tsome\tpatients,\tand\tnutrition\tsupport\tvia\tenteral\ttube\nfeeding\tmay\tbecome\tnecessary.\tAntidiarrheal\... | [
0.04393152892589569,
-0.008110073395073414,
0.060319967567920685,
-0.011484893038868904,
-0.0870807021856308,
0.01654326170682907,
0.09732610732316971,
0.026580046862363815,
-0.0040227873250842094,
0.02068803273141384,
0.11883556842803955,
0.012552105821669102,
0.03679933771491051,
0.04324... |
classes\tof\tmedications\trecommended\tto\treduce\toutput\tin\tHOS.\nRestorative\n\tproctocolectomy\twith\tileal\tpouch\tanal\tanastomosis\nRestorative\t\nproctocolectomy\n\twith\t\nileal\tpouch\tanal\tanastomosis\t(IPAA)\n\thas\tevolved\tas\tthe\nsurgical\ttreatment\tof\tchoice\tfor\tpatients\twith\tmedically\trefract... | [
-0.008957315236330032,
-0.006601355504244566,
0.05570574849843979,
-0.03054741956293583,
-0.10261888056993484,
-0.02021961472928524,
0.03442789986729622,
-0.009392532519996166,
-0.03771570324897766,
0.02196457050740719,
0.06698546558618546,
0.04947996139526367,
-0.028220416978001595,
0.033... |
requiring\ta\tcolectomy,\tthe\tmajority\telect\tto\thave\tan\tIPAA.\tThis\tprocedure\tinvolves\tremoval\tof\tthe\nentire\tcolon\tand\trectum\t(proctocolectomy)\twhile\tpreserving\tthe\tanal\n\tsphincter,\tfollowed\tby\tcreation\nof\ta\treservoir\tusing\ta\tportion\tof\tthe\tdistal\tileum\t(ileal\tpouch).\tThis\tpouch\t... | [
-0.000014809867025178391,
-0.020390501245856285,
0.07010948657989502,
-0.07509388774633408,
-0.1143270954489708,
-0.01577259786427021,
0.07329434156417847,
-0.010692895390093327,
0.04001745954155922,
0.03776839002966881,
0.1191144809126854,
0.0111876605078578,
0.0012109874514862895,
0.0578... |
(pouch-anal\tanastomosis)\tto\tthe\tpreserved\tanal\tcanal\tin\twhich\tthe\tdiseased\tmucosa\thas\tbeen\nremoved,\tthus\tmaintaining\tcontinence\tand\tvoluntary\tfunction.\tThis\toffers\ta\tcure\tfor\tthe\tdisease\nprocesses\tand\tavoids\ta\tpermanent\tileostomy.\nConstruction\tusually\trequires\tuse\tof\n\tthe\tdistal... | [
-0.0023416492622345686,
-0.006735933944582939,
0.036123935133218765,
-0.047238484025001526,
-0.15535004436969757,
-0.033267293125391006,
0.08022192865610123,
-0.003737435443326831,
-0.035819970071315765,
0.04653974995017052,
0.09212134778499603,
-0.006877240724861622,
0.04183002561330795,
... |
the\tdistalmost\t30\tto\t40\tcm\tof\tileum,\twith\tpouch\tconfiguration\ndetermined\tby\tthe\tnumber\tof\tbowel\tlimbs\tused.\tThe\tmost\tcommon\tpouch\tis\tthe\t\nileal\tJ-pouch\n,\twhich\nuses\ttwo\tlimbs\tof\tbowel\t(\nFig.\t27.8\n)\tto\tcreate\ta\t“J”-shaped\treservoir\tout\tof\tthe\tpatient’s\town\tsmall | [
-0.024649882689118385,
0.023530740290880203,
0.015212847851216793,
-0.0918336734175682,
-0.15113313496112823,
-0.013537176884710789,
0.03187023475766182,
0.01163791585713625,
-0.007108359131962061,
0.03003215417265892,
0.11187192797660828,
-0.0066915350034832954,
0.07028833776712418,
0.034... |
)\tto\tcreate\ta\t“J”-shaped\treservoir\tout\tof\tthe\tpatient’s\town\tsmall\nintestine.\tIt\tis\tthe\tpreferred\tileal\tpouch\tbecause\tof\tthe\tefficiency\tof\tconstruction\tand\toptimal\nfunctional\tresults\tby\tallowing\ta\tmore\tnormal\n\troute\tof\tdefecation.\tAlternatives\tto\tthe\tJ-pouch | [
-0.010189945809543133,
-0.022976387292146683,
0.037329476326704025,
-0.04395119100809097,
-0.1891898810863495,
-0.012562857940793037,
0.06360670924186707,
0.04238228127360344,
-0.015751810744404793,
0.03531903773546219,
0.1026652380824089,
-0.004678615368902683,
0.013594206422567368,
0.047... |
configuration\tinclude\tthree-\tand\tfour-limbed\tpouches,\tsuch\tas\tan\t\nS-pouch\n\tor\t\nW-pouch\n.\tThese\nalternative\tconfigurations\tare\trarely\tperformed\tbecause\tof\tthe\tcomplexity\tof\tconstruction.\tThe\tfinal\ndecision\tas\tto\twhich\ttype\tis\tused\tremains\tat\tthe\tdiscretion\tof\tthe\tsurgeon.\nFIG.... | [
-0.006240613758563995,
-0.0034783941227942705,
0.00013900548219680786,
-0.08124075829982758,
-0.1213146522641182,
-0.026226745918393135,
0.017676495015621185,
0.011803456582129002,
-0.030611826106905937,
0.027880148962140083,
0.049033138900995255,
-0.05735466256737709,
0.02529429830610752,
... |
J-pouch.\n\t\nSource:\n\t(Cleveland\tClinic,\tCleveland,\tOhio,\tUSA.\t)\nWith\tany\tpouch\tsurgery\tthe\trecovery\tis\tlonger\tthan\tin\tthose\twho\thave\ta\tconventional\tileostomy\nbecause\tof\tthe\ttwo-stage\tprocedure.\tThere\twill\tbe\ta\tperiod\tof\tadaptation\tof\tthe\tnew\treservoir\tafter | [
0.02040722779929638,
-0.02899234928190708,
0.05002402141690254,
-0.08015542477369308,
-0.15649297833442688,
0.018064267933368683,
0.04338657855987549,
-0.01741448976099491,
-0.005191080272197723,
0.0597635880112648,
0.08236820250749588,
-0.0004649447510018945,
0.021764036267995834,
0.03466... |
the\tileostomy\tis\tclosed.\tInitially,\tthere\tcould\tbe\tup\tto\t15\tbowel\tmovements\ta\tday\twith\tsome\tproblems\nof\tcontrol\tand\tthe\tneed\tto\n\tget\tup\tseveral\ttimes\tat\tnight.\tEventually,\tmost\tpatients\texperience\tfour\tto\nsix\tbowel\tmovements\tdaily,\thave\tgood\tcontrol,\tand\tare\tnot\ttroubled\t... | [
-0.004731215536594391,
-0.008801771327853203,
0.06447210162878036,
-0.05979302525520325,
-0.09875834733247757,
-0.00467207096517086,
0.07005766779184341,
-0.010995940305292606,
-0.015839824452996254,
0.024992674589157104,
0.08172102272510529,
0.004637666046619415,
0.025832924991846085,
0.0... |
improves\tover\ttime\tas\tthe\tpouch\tcapacity\tgradually\tincreases.\nA\t\nKoch\tpouch\n\tis\ta\ttype\tof\tappliance-less\tileostomy\tthat\tuses\tan\tinternal\treservoir\twith\ta\tone-way\nvalve,\tconstructed\tfrom\ta\tloop\tof\tintestine\tthat\tis\tattached\n\tto\tthe\tabdominal\twall\twith\ta\tskin-level | [
0.05974048003554344,
-0.042618706822395325,
0.11201714724302292,
-0.07677654922008514,
-0.1258724480867386,
0.0014080929104238749,
0.05562358722090721,
0.004716783296316862,
-0.06096523627638817,
0.05446542799472809,
0.05219242349267006,
-0.013716892339289188,
0.016563795506954193,
0.01583... |
to\tthe\tabdominal\twall\twith\ta\tskin-level\nstoma.\tPatients\tmust\tinsert\ta\ttube\tor\tcatheter\tinto\tthe\tstoma\tto\topen\tthe\tvalve\tand\tallow\tdrainage\tof\nthe\tileostomy\tcontents.\tThe\ttechnical\tdifficulties\tof\tsurgical\tconstruction\tand\tthe\tpotential\tfor\ncomplications\thas\tled\tto\tdecreased\tu... | [
-0.00012145289656473324,
-0.0021199346520006657,
0.047638773918151855,
-0.06631113588809967,
-0.17657864093780518,
-0.029897645115852356,
0.05608276277780533,
0.006500212009996176,
-0.012718704529106617,
0.04902346432209015,
0.08336795121431351,
0.006236737128347158,
0.04890158772468567,
0... |
Medical\tmanagement\nAcute\tand\tchronic\tcomplications\tcan\tnecessitate\n\tremoval\tof\tthe\tileal\tpouch\tand\teventual\nconstruction\tof\ta\tpermanent\tileostomy.\t\nPouchitis\n\tis\ta\tnonspecific\tinflammation\tof\tthe\tmucosal\ttissue\nforming\tthe\tileal\tpouch\tand\tis\tthe\tmost\tfrequent\tlong-term\tcomplica... | [
0.011481010355055332,
-0.016773689538240433,
0.06714896857738495,
-0.048668477684259415,
-0.15286889672279358,
-0.007069775369018316,
0.05452151969075203,
0.009750971570611,
0.022276470437645912,
0.02806740812957287,
0.09045100957155228,
-0.003628733102232218,
0.015969641506671906,
0.02513... |
The\tcause\tof\tpouchitis\tis\tnot\tentirely\tclear,\tbut\tit\tmay\tbe\trelated\tto\tbacterial\tovergrowth,\nunrecognized\tCrohn’s\tdisease,\timmunologic\tchanges,\tbile\tsalt\n\tmalabsorption,\tor\tinsufficient\tSCFA\nproduction.\tThe\tusual\tpresenting\tsymptoms\tinclude\tincreased\tstool\tfrequency,\turgency, | [
0.008323002606630325,
-0.07528695464134216,
0.027810828760266304,
-0.036488525569438934,
-0.12742513418197632,
0.027774501591920853,
0.023397309705615044,
0.029408957809209824,
0.014228042215108871,
0.09420953691005707,
0.11785895377397537,
-0.05184219032526016,
0.0017139799892902374,
0.05... |
incontinence,\tnocturnal\tseepage,\tabdominal\tcramps,\tand\tpelvic\tdiscomfort.\tPouchitis\tmay\tbe\nclassified\tbased\ton\tthe\tcause,\tdisease\tduration\tand\tactivity,\tand\tresponse\tto\tmedical\ttherapy.\tIn\tthe\nmajority\tof\tpatients\tthe\tetiology\tof\tpouchitis\tis\tnot\tclear\tand\tthus\ttermed\tas\tidiopat... | [
-0.011060629040002823,
-0.05110520124435425,
0.024437744170427322,
0.003333542263135314,
-0.12857043743133545,
0.0051069073379039764,
0.0669265165925026,
0.05077721178531647,
-0.04813666641712189,
0.02047458291053772,
0.07895016670227051,
0.05622277036309242,
0.010105541907250881,
0.088052... |
pouchitis\n(\nZezos\tand\tSaibil,\t2015\n).\nPouch\tendoscopy\tis\tthe\tmain\tmodality\tin\tthe\tdiagnosis\tand\tdifferential\tdiagnosis\tin\tpatients\twith\npouch\tdysfunction.\tAntibiotic\ttherapy\tis\tthe\tmainstay\tof\ttreatment\tfor\tactive\tpouchitis.\tSome\npatients\tmay\tdevelop\tdependency\ton\tantibiotics,\tr... | [
-0.006413739640265703,
-0.044495996087789536,
0.002077140612527728,
-0.024356620386242867,
-0.10448449105024338,
-0.04156476631760597,
0.03492889553308487,
0.07395951449871063,
-0.05444695055484772,
0.008930061012506485,
0.08856930583715439,
0.039998237043619156,
0.05505931004881859,
0.120... |
evidence\tfor\tthe\tuse\tof\tprobiotics\tin\tmaintenance\ttreatment\tof\tpouchitis\tis\n\tcontroversial.\tThere\tmay\nbe\troles\tfor\tpostoperative\tprobiotic\tsupplementation\tto\tprevent\tpouchitis\tand\tin\tmaintaining\nremission\tin\tantibiotic-dependent\tpouchitis\t(\nShen\tet\tal,\t2014\n).\tClinical\texpert-gene... | [
-0.060822416096925735,
-0.04489675909280777,
0.030953142791986465,
-0.010271345265209675,
0.002543909940868616,
0.048025671392679214,
0.016740554943680763,
0.055710569024086,
-0.002093982184305787,
0.05639846250414848,
0.1299257129430771,
-0.022645018994808197,
0.006848692428320646,
0.0872... |
Shen\tet\tal,\t2014\n).\tClinical\texpert-generated\tguidelines\nconcur\tthat\tthe\tprobiotic\tcalled\tVSL#3\tcan\tbe\teffective\tfor\tpreventing\trecurrence\tof\tpouchitis\n(\nCiorba,\t2012\n;\t\nShen\tet\tal,\t2014\n).\nMedical\tnutrition\ttherapy\nPatients\twho\thave\n\tundergone\tan\tIPAA\tprocedure\tusually\trequi... | [
-0.0435856394469738,
0.018003331497311592,
0.037475358694791794,
-0.044654421508312225,
-0.09592252224683762,
0.004715976305305958,
0.07168116420507431,
-0.04052254557609558,
-0.008084125816822052,
0.06494145840406418,
0.11470252275466919,
-0.06848380714654922,
0.09281317889690399,
0.00121... |
12\ninjections.\tThe\tcause\tof\tvitamin\tB\n12\n\tdeficiency\tmay\tbe\tmultifactorial:\t(1)\treduced\tabsorptive\tcapacity\ndue\tto\tdistal\tileal\tresection\t(main\tsite\tof\tvitamin\tB\n12\n\tabsorption);\t(2)\tbacterial\tovergrowth\tis\ta\twell-\nknown\tphenomenon\tin\tpatients\twith\tan\tileal\tpouch,\tand\tanaero... | [
0.023304086178541183,
-0.03514055907726288,
0.038639239966869354,
-0.05750207602977753,
-0.12970535457134247,
0.03180510550737381,
0.061098307371139526,
0.03608701750636101,
-0.01455000601708889,
0.08982273191213608,
0.11857476085424423,
-0.035783182829618454,
0.003138529136776924,
0.04643... |
12\n\tin\nits\tfree\tand\tintrinsic\n\tforms,\tleading\tto\ta\tdecreased\tconcentration\tavailable\tfor\tabsorption;\tand\t(3)\ninsufficient\tB\n12\n\tintake.\tThe\tanemia\texperienced\tby\tpatients\tafter\tIPAA\tcan\talso\tbe\tdue\tto\tiron | [
0.01636447198688984,
-0.04241913929581642,
0.01686892658472061,
-0.0254674032330513,
-0.09449554979801178,
0.035026296973228455,
0.1402510702610016,
0.04710494726896286,
-0.054436665028333664,
0.043035104870796204,
0.061396531760692596,
-0.02129986882209778,
-0.031820785254240036,
0.016564... |
deficiency\tbecause\tof\timpaired\tabsorption,\tdecreased\toral\tintake,\tincreased\trequirements,\tand\tblood\nloss.\nPatients\twith\ta\tpouch\toften\tdescribe\tspecific\tfood\tsensitivities\tthat\tmay\trequire\tdiet\talteration,\neven\tmore\tso\tthan\n\tdo\tpatients\twith\tpermanent\tileostomy\t(\nUnited\tOstomy\tAss... | [
0.014740782789885998,
-0.051503781229257584,
0.03090156801044941,
-0.03642237186431885,
-0.1362002044916153,
-0.010525702498853207,
0.07824413478374481,
0.04795954376459122,
-0.02957424521446228,
0.05334943160414696,
0.1145583987236023,
-0.021727457642555237,
0.01149886567145586,
0.0378781... |
United\tOstomy\tAssociations\tof\tAmerica,\n2011\n).\tProblems\toften\treported\tinclude\tobstructive\tsymptoms\tand\tincreased\tstool\toutput,\tfrequency,\nand\tgas.\tThe\tincidence\tof\tobstruction\tmay\tbe\tavoided\tby\tlimiting\tinsoluble\tfibers,\tchewing\nthoroughly,\tand\tconsuming\tsmall\tmeals\tfrequently\tthr... | [
0.03647749498486519,
-0.08417999744415283,
0.05360972508788109,
-0.01708335056900978,
-0.12531661987304688,
0.03931381180882454,
0.08177527785301208,
-0.04659685865044594,
0.001913734246045351,
0.028276046738028526,
0.11335993558168411,
-0.020169274881482124,
0.01973206363618374,
0.0255563... |
experiment\twith\ttiming\tof\tmeals\tby\teating\n\tlarger\tmeals\tearlier\tin\tthe\tday\tand\tlimiting\tthe\tamount\tof\nfood\tand\tfluid\tintake\ttoward\tthe\tend\tof\tthe\tday\tto\tminimize\tsleep\tinterruptions.\tThe\tsame\tdietary\nmeasures\tthat\tare\tused\tto\treduce\texcessive\tstool\toutput\t(reduced\tcaffeine,... | [
0.010292859748005867,
-0.05746966972947121,
0.03348512202501297,
-0.034750066697597504,
-0.0700719878077507,
-0.017153359949588776,
0.07976526021957397,
0.02254747413098812,
0.021322622895240784,
0.036994826048612595,
0.06924226880073547,
-0.0139808664098382,
0.07286123931407928,
0.0274008... |
lactase-deficient,\tand\tlimitation\tof\tfoods\thigh\tin\tsimple\tsugars,\tfructose,\tand\tsorbitol)\twill\tlikely\nreduce\tstool\tvolume\tand\tfrequency\tin\tpatients\n\twith\tIPAA.\nCLINICAL\tCASE\tSTUDY\nJimmy\tis\ta\t76-year-old\tmale\twith\ta\trecent\temergent\tsmall\tbowel\tresection\tdue\tto\ta\truptured\tmesh | [
0.02065635472536087,
-0.10048055648803711,
0.02124781534075737,
0.0018159436294808984,
-0.038911957293748856,
-0.006704940460622311,
0.04236719012260437,
0.10081388801336288,
-0.07494017481803894,
0.020126357674598694,
0.09892165660858154,
-0.045085106045007706,
-0.00981714017689228,
0.042... |
hernia\tcausing\ttraumatic\tinjury\tto\this\tsmall\tintestine.\tHe\thad\ta\tdifficult\tpostoperative\tcourse\ncomplicated\tby\t\nClostridium\tdifficile\n\tinfection,\tclinically\tinvoluntary\tweight\tloss,\tdiarrhea,\tand\ndehydration.\tAt\this\treadmission\tfor\t\nC.\tdifficile\n\tinfection,\ta\tnutrition\n\tconsult\t... | [
0.012902441434562206,
-0.024325314909219742,
0.0593661330640316,
0.0005270665278658271,
-0.08892470598220825,
0.0015954341506585479,
0.0804547518491745,
0.04063475877046585,
-0.038564007729291916,
0.082789845764637,
0.04532298073172569,
-0.005310663487762213,
0.03462065011262894,
0.0603590... |
C.\tdifficile\n\tinfection,\ta\tnutrition\n\tconsult\twas\treceived\tfor\nmanagement\tof\tdiarrhea\tand\thydration\tstatus,\tand\tto\tassess\tfor\tany\tnutrient\tmalabsorption.\nNutrition\tassessment\n•\t\nAnatomy:\tDuring\tsurgery,\t100\tcm\tof\tthe\tsmall\tintestine\twas\tremoved,\tincluding\tthe\tileocecal\nvalve\t(... | [
0.026097362861037254,
-0.01267631072551012,
0.04509318619966507,
-0.034523434937000275,
-0.10898520052433014,
0.03058888576924801,
0.1096559688448906,
0.027450131252408028,
-0.02880674973130226,
0.06590324640274048,
0.10571789741516113,
-0.06103767827153206,
0.05563835799694061,
0.02812058... |
valve\t(ICV).\tThe\tmajority\tof\tthe\tcolon\tremains\tintact.\n•\t\nOral\tintake\thistory:\tDecline\tin\tappetite\tand\toral\tintake\tsince\tsurgery\tdue\tto\tvery\tpoor\nappetite\tand\n\tdiarrhea.\tBefore\tadmission\tJimmy\twas\teating\t¼\tof\this\tusual\tmeals\twith\t½\tof\nthe\tusual\tsnacks\tand\ttaking\tone\toral... | [
-0.018859678879380226,
-0.05357866361737251,
0.03513053059577942,
-0.05614025890827179,
-0.11558526009321213,
-0.006991990376263857,
0.09302671998739243,
0.0008777768816798925,
0.018747160211205482,
0.023043951019644737,
0.05081408843398094,
-0.042591843754053116,
0.04675847664475441,
-0.0... |
tea,\tand\twater,\tand\testimates\the\tis\ttaking\tin\t3\tto\t4\tcups\tper\tday.\n•\t\nCurrent\tintake:\tIn\tthe\thospital,\tJimmy\tis\teating\t50%\tof\tmeals\tprovided,\ttolerating\tsnacks,\nand\tsipping\tup\tto\t500\tmL\tof\tcommercial\telectrolyte\tbeverage\tper\tday.\n\tHe\treports\tnever\nfeeling\thungry,\tis\tapa... | [
-0.02492464706301689,
-0.06899764388799667,
0.052620552480220795,
-0.03429577499628067,
-0.09905749559402466,
0.0005042940028943121,
0.13939328491687775,
0.013509098440408707,
-0.03214452415704727,
0.03813180699944496,
0.07400824874639511,
-0.041053250432014465,
0.04377337917685509,
0.0207... |
more\tbathroom\ttrips.\n•\t\nWeight\tand\tbody\tmass\tindex\t(BMI):\tHeight:\t177.8\tcm\t(70\tinches),\tWeight:\t75\tkg\t(165\tlb),\nBMI:\t23.7\tkg/m\n2\n•\t\nUsual\tbody\tweight\t(UBW):\t100\tkg\t(220\tlb):\t25%\tweight\tloss\t×\t3\tmonths\t(clinically\nsignificant\tloss)\n•\t\nPhysical\texamination:\tpale\tskin;\tdar... | [
0.04117906838655472,
-0.03435048460960388,
-0.0010023232316598296,
0.027238797396421432,
-0.09431600570678711,
-0.007918537594377995,
0.005302015691995621,
0.08028938621282578,
-0.05364064499735832,
-0.013833862729370594,
0.022079572081565857,
-0.09236616641283035,
0.02944670058786869,
0.0... |
depression\tat\ttemples;\tscapula\npronounced;\tnoted\tlosses\tat\tquadriceps,\tgastrocnemius,\tand\ttriceps;\tno\tedema\tnoted\n•\t\nFunctional\tcapacity:\tlow\tenergy\tlevel\tover\tpast\t3\tmonths,\tunable\tto\tgarden\tor\tcook\tmeals,\nwhich\the\tpreviously\tenjoyed,\tfatigued\tand\ttired\tall\tthe\ttime,\tmemory\ts... | [
0.02079329453408718,
-0.03134896606206894,
0.049368809908628464,
0.037779223173856735,
-0.07585856318473816,
0.06322690844535828,
0.07760348170995712,
0.0863131508231163,
0.02712290734052658,
0.017738118767738342,
0.05009269714355469,
0.01563303917646408,
0.04420280084013939,
-0.0062797572... |
•\t\nMedications:\tstarted\tloperamide\t2\tmg\tbefore\tmeals\tand\tbedtime,\tsenior\tmultivitamin,\npotassium\tchloride\n\t(KCl)\tsustained-release\ttablet,\tlisinopril\tdose\treduced\tdue\tto\tweight\tloss,\nstatin\tdiscontinued\tdue\tto\tcholesterol\tlevels\tnormalized\twithin\ta\tfew\tmonths\tof\tsurgery\n•\t\n24-ho... | [
-0.02867789939045906,
-0.02407841570675373,
0.001047421246767044,
0.003654423402622342,
-0.0939778983592987,
-0.02619941532611847,
0.023494897410273552,
0.09286848455667496,
0.0332181416451931,
-0.028907980769872665,
0.08181735128164291,
-0.030429821461439133,
0.033966802060604095,
-0.0214... |
•\t\n24-hour\turine\tand\tstool\toutput:\t650\tmL\tand\t2200\tmL\n•\t\nPertinent\tlabs:\thigh\tserum\tsodium\t(147),\tlow\tserum\tpotassium\t(3.0\tmEq/L),\tlow\tnormal\nserum\tmagnesium\t(1.3),\thigh\tblood\turea\tnitrogen\t(BUN):\t7.6\tmmol/L,\tstool\ttoxin\tanalysis\tfor\nC\tdifficile:\n\tpositive\n•\t\nCurrent\tdiet... | [
0.007588519249111414,
-0.05482569336891174,
0.005139444954693317,
0.02404024638235569,
-0.06304721534252167,
-0.03716281056404114,
0.049234479665756226,
0.10373952239751816,
-0.061057284474372864,
0.0010571173625066876,
0.05311783403158188,
-0.02157195657491684,
0.030915526673197746,
0.036... |
•\t\nCurrent\tdiet:\tGeneral\tdiet\nNutrition\tdiagnostic\tstatements\n•\t\nSevere\tprotein\tcalorie\tmalnutrition\trelated\tto\tpoor\tappetite\tas\tevidenced\tby\tenergy\tintake\n25%\tto\t50%\tx\t3\tmonths,\tinvoluntary\tweight\tloss\tat\t25%\tx\t3\tmonths,\tsubcutaneous\tfat\tloss,\nmuscle\tloss,\tand\tdecline\tin\ts... | [
0.019051939249038696,
-0.0643405169248581,
0.031480126082897186,
0.015638964250683784,
-0.07367278635501862,
-0.010520439594984055,
0.12123267352581024,
0.11233039200305939,
-0.09065037220716476,
0.022563356906175613,
0.09455351531505585,
-0.019131777808070183,
0.05677975341677666,
0.06064... |
muscle\tloss,\tand\tdecline\tin\tstrength\tand\tfunctional\tcapacity\n•\t\nSuboptimal\tprotein-energy\tintake\trelated\tto\taltered\tgastrointestinal\n\t(GI)\tfunction\tas\nevidenced\tby\tdiarrhea,\tinvoluntary\tweight\tloss\tat\t25%\tx\t3\tmonths,\tUBW\t220\tlbs\nInterventions\n•\t\nEstimated\tenergy\tneeds:\t2625\tto... | [
-0.009459626860916615,
-0.07187113910913467,
0.05193289741873741,
0.02787484973669052,
-0.08409173041582108,
-0.024929003790020943,
0.11000673472881317,
0.08352140337228775,
-0.08605833351612091,
0.032652150839567184,
0.04792534187436104,
-0.05524371191859245,
0.04416044056415558,
0.064123... |
•\t\nEstimated\tprotein\tneeds:\t115\tto\t150\tg\tprotein/day\t(1.5\tto\t2.0\tg\tprotein/kg/day)\n•\t\nNutrition\tgoal(s):\tOral\tintake\tto\tmeet\testimated\tneeds,\tdecrease\tstool\toutput\tto\tthe\tpoint\nwhere\tpatient’s\thydration\n\tis\tmaintained;\tmaintain\toptimal\tmicronutrient\tstatus.\n•\t\nReplace\telectro... | [
-0.01536571141332388,
0.0038727144710719585,
-0.0017112441128119826,
-0.013593771494925022,
-0.05114093795418739,
0.015113200061023235,
0.05522545054554939,
0.1264447420835495,
-0.027067052200436592,
-0.022108998149633408,
0.07205566763877869,
-0.012514270842075348,
0.06220623850822449,
0.... |
•\t\nReplace\telectrolyte\tand\tfluid\tlosses.\tMonitor\tfluid\tbalance.\n•\t\nContinue\tgeneral\tdiet\twith\tmoderate\tinsoluble\tfiber\tuntil\tdiarrhea\tis\tunder\tcontrol,\treduce\nsimple\tsugars\tin\tthe\tdiet.\tPatient\tto\tmake\thigh-salt,\thigh-starch,\tlow-simple\tsugar\tfood\nchoices\tfrom\tthe\tmenu.\tEncoura... | [
0.0004603974230121821,
-0.05684449151158333,
0.0773739144206047,
-0.018833843991160393,
-0.10187587141990662,
-0.023335568606853485,
0.10850901901721954,
0.03253908082842827,
-0.03583440184593201,
0.014795465394854546,
0.07880309969186783,
-0.028712350875139236,
0.06198591738939285,
0.0180... |
•\t\nProvide\tsalty/starchy\n\tsnacks\tbetween\tmeals.\tEncourage\t“thickening\tfoods,”\tsuch\tas\tboiled\nwhite\trice,\tpasta,\tnoodles,\tbread,\tpotatoes,\tbanana,\toatmeal,\tapplesauce,\tpeanut\tbutter,\ncheese,\tand\ttapioca\tpudding.\n•\t\nSip\t2\tL\tof\toral\trehydration\tsolution\t(ORS)\tbetween\tmeals\tas\tan\t... | [
-0.014803405851125717,
-0.0941646546125412,
0.02909582480788231,
-0.004760767333209515,
-0.09872514754533768,
-0.01611102558672428,
0.12567947804927826,
0.014923849143087864,
-0.03483116626739502,
0.028469735756516457,
0.11176513135433197,
-0.038362953811883926,
0.04559923708438873,
0.0200... |
•\t\nAvoid\tcaffeinated\tand\thypertonic\tfluids.\n•\t\nConsider\ttrial\tof\tsoluble\tfiber\tsupplement\tto\tslow\n\tdown\ttransit\ttime\tand\tthicken\tstool.\n•\t\nContinue\tantidiarrheal\tmedications\twith\tdosage\tadjusted\tby\tphysician\tdepending\ton\tvolume\nand\tconsistency\tof\tstool.\n•\t\nDiet\teducation:\tDi... | [
-0.0072665028274059296,
-0.03552853688597679,
0.035797119140625,
0.0055706254206597805,
-0.06310562044382095,
0.0003567351377569139,
0.0800284892320633,
0.059167519211769104,
-0.009071603417396545,
-0.008413400501012802,
0.0875668078660965,
0.019125135615468025,
0.07648658007383347,
0.0397... |
status,\tincluding\tintake\tof\twater-miscible\tversions\tof\tfat-soluble\tvitamins,\tand\tvitamin\tB\n12\nshots\tmonthly,\tand\tmaintaining\tadequate\tweight\tand\thydration\n\tstatus\twith\tchanged\tbowel\nlength.\n•\t\nRecommend\toutpatient\tfollow\tup\twith\tnutrition\tprofessional\tspecializing\tin\tGI\tnutrition.... | [
-0.023413049057126045,
-0.008501901291310787,
0.050143301486968994,
0.017238812521100044,
-0.03270098939538002,
0.027828266844153404,
0.07814403623342514,
0.06252221763134003,
-0.04460819810628891,
-0.03599591553211212,
0.0964750349521637,
-0.034264545887708664,
0.03019814006984234,
0.0231... |
•\t\nEvaluate\tmicronutrient\tstatus.\nMonitoring\tand\tevaluation\n•\t\nMonitor\toral\tintake\tvia\tcalorie\tcounts\twith\ta\tgoal\tof\tmeeting\t75%\tto\t100%\tof\testimated\nenergy\tand\tprotein\tneeds.\n•\t\nMonitor\tstool\tand\turinary\toutput\tand\tweight\ttrends\tto\tassess\tneed\tfor\thome\tintravenous | [
0.012140519917011261,
-0.02468368224799633,
0.017301348969340324,
0.014699303545057774,
-0.11834648251533508,
0.022161733359098434,
0.1157214418053627,
0.02836763672530651,
0.011084738187491894,
0.03629458695650101,
0.11875662207603455,
-0.06319770961999893,
0.014976885169744492,
0.0325731... |
fluids\t(HIVF)\tor\thome\tparenteral\tnutrition\t(HPN)\tif\tweight\tand\tfluid\tstatus\tdo\tnot\tstabilize\nwith\tincreased\tintake\tand\tORS.\nUseful\twebsites\nCeliac\tDisease\tFoundation\nCeliac\tSprue\tAssociation\nCrohn’s\tand\tColitis\tFoundation\tof\tAmerica\nGluten\tIntolerance\tGroup\nInternational\tScientific... | [
-0.03551135212182999,
-0.10430862009525299,
0.018846554681658745,
0.007651669904589653,
-0.013940470293164253,
0.004959027748554945,
0.07996596395969391,
0.07326894998550415,
-0.012215280905365944,
0.026502540335059166,
0.09036437422037125,
-0.06558400392532349,
0.0026009653229266405,
0.07... |
International\tScientific\tAssociation\tfor\tProbiotics\tand\tPrebiotics\nMonash\tUniversity\tLow\tFODMAP\tDiet\nNational\tInstitute\n\tof\tDiabetes\tand\tDigestive\tand\tKidney\tDiseases\nNutrition\tin\tImmune\tBalance\t(NiMBAL)\nUnited\tOstomy\tAssociations\tof\tAmerica,\tInc.\nUniversity\tof\tVirginia\tGI\tNutrition... | [
0.06750167161226273,
-0.08208710700273514,
0.02129020169377327,
0.020225603133440018,
-0.08062268793582916,
-0.0026840867940336466,
0.048006828874349594,
-0.022914554923772812,
-0.011563767679035664,
0.045922230929136276,
0.14126284420490265,
-0.09130192548036575,
-0.020615825429558754,
0.... |
USDA\tFood\tComposition\tDatabases\nWound,\tOstomy\tand\tContinence\tNurses\tSociety\nPortions\tof\tthis\tchapter\twere\twritten\tby\tGail\tCresci,\tPhD,\tRDN,\tLD,\tCNSC\tand\tArlene\tEscuro,\tMS,\tRDN,\nCNSC. | [
0.006023210473358631,
-0.0897441953420639,
-0.016789855435490608,
-0.042236458510160446,
-0.132979616522789,
-0.019969221204519272,
0.059436291456222534,
0.017828000709414482,
0.029370233416557312,
0.05224042013287544,
0.10872257500886917,
-0.06314609199762344,
0.018044307827949524,
0.0170... |
28\nMedical\tnutrition\ttherapy\tfor\nhepatobiliary\tand\tpancreatic\tdisorders\nJeanette\tM.\tHasse,\tPhD,\tRDN,\tLD,\tCNSC,\tFADA,\tLaura\tE.\tMatarese,\tPhD,\tRDN,\tLDN,\tCNSC,\tFADA,\tFASPEN,\tFAND\nKEY\tTERMS\nacalculous\tcholecystitis\nalcoholic\tliver\tdisease\naromatic\tamino\tacids\t(AAAs)\nascites\nbile\nbran... | [
0.002100963843986392,
-0.07429218292236328,
0.02972211129963398,
-0.009687406942248344,
-0.14476723968982697,
-0.019935481250286102,
0.04695679247379303,
0.06832549721002579,
0.008357705548405647,
0.07466986775398254,
0.11590298265218735,
-0.004137047566473484,
0.04002119228243828,
0.05711... |
calculi\ncholangitis\ncholecystectomy\ncholecystitis\ncholedocholithiasis\ncholelithiasis\ncholestasis\ncirrhosis\ndetoxification\ndry\tweight\nencephalopathy\nend\tstage\tliver\tdisease\t(ESLD)\nfasting\thypoglycemia\nfatty\tliver\nfulminant\tliver\tdisease\nhemochromatosis\nhepatic\tencephalopathy\nhepatic\tfailure\n... | [
-0.005046600475907326,
-0.031999386847019196,
-0.010356343351304531,
0.012504090555012226,
-0.11161646991968155,
-0.04307349771261215,
-0.015664275735616684,
0.07659903913736343,
-0.05456103757023811,
0.04106737673282623,
0.023714056238532066,
0.026452472433447838,
0.03686118870973587,
-0.... |
hepatic\tfailure\nhepatic\tosteodystrophy\nhepatic\tsteatosis\nhepatitis\nhepatorenal\tsyndrome\nicteric\njaundice\nKayser-Fleischer\tring\nKupffer\tcells\nnonalcoholic\tfatty\tliver\tdisease\n\t(NAFLD)\nnonalcoholic\tsteatohepatitis\t(NASH)\noxidative\tdeamination\npancreaticoduodenectomy\t(Whipple\tprocedure)\npancre... | [
0.036994677037000656,
-0.10274282097816467,
-0.013207916170358658,
0.005582295823842287,
-0.10273005068302155,
-0.033305294811725616,
0.004468908999115229,
0.03969074413180351,
-0.061055563390254974,
0.057337719947099686,
0.014040635898709297,
0.01094822771847248,
0.016293605789542198,
0.0... |
pancreatic\tislet\tautotransplantation\npancreatitis\nparacentesis\nportal\thypertension\nportal\tsystemic\tencephalopathy\npostcholecystectomy\tsyndrome\nprimary\tbiliary\tcirrhosis\t(PBC)\nprimary\tsclerosing\tcholangitis\t(PSC)\nsecondary\tbiliary\tcirrhosis\nsteatorrhea\ntransamination | [
-0.023958755657076836,
-0.052652884274721146,
-0.015934867784380913,
0.0012316616484895349,
-0.09966552257537842,
0.011958467774093151,
0.027020497247576714,
0.06754196435213089,
-0.014068908989429474,
0.0368812195956707,
0.00013535976177081466,
0.002756651723757386,
0.009002787992358208,
... |
varices\nWernicke\tencephalopathy\nWilson’s\tdisease\nThe\tliver\tis\tof\tprimary\timportance;\tone\tcannot\tsurvive\twithout\ta\tliver.\tThe\tliver\tand\tpancreas\tare\tessential\tto\ndigestion\tand\tmetabolism.\tAlthough\tit\tis\timportant,\tthe\tgallbladder\tcan\tbe\tremoved,\tand\tthe\tbody\twill\tadapt | [
0.05070602893829346,
-0.06069795787334442,
0.0736716091632843,
-0.028176432475447655,
-0.1380673497915268,
0.013986454345285892,
0.07693447172641754,
0.030675623565912247,
0.007943389937281609,
0.06624263525009155,
0.09728389233350754,
-0.0025600960943847895,
0.01958279497921467,
0.0362872... |
comfortably\tto\tits\tabsence.\tKnowledge\tof\tthe\tstructure\tand\tfunctions\tof\tthese\torgans\tis\tvital.\tWhen\tthey\tare\ndiseased,\tthe\tnecessary\n\tmedical\tnutrition\ttherapy\t(MNT)\tis\tcomplex.\nPhysiology\tand\tfunctions\tof\tthe\tliver\nStructure\nThe\tliver\tis\tthe\tlargest\tgland\tin\tthe\tbody,\tweighi... | [
0.026842884719371796,
-0.04246506839990616,
0.08931470662355423,
0.024694878607988358,
-0.12243092805147171,
0.005906868260353804,
0.11385486274957657,
-0.0004007437382824719,
-0.018207527697086334,
0.05492062121629715,
0.06523694843053818,
-0.03906770795583725,
0.011756316758692265,
0.029... |
left.\tThe\tright\tlobe\tis\tfurther\tdivided\tinto\tthe\tanterior\tand\tposterior\tsegments;\tthe\tright\tsegmental\tfissure,\twhich\ncannot\tbe\tseen\texternally,\tseparates\tthe\tsegments.\tThe\texternally\n\tvisible\tfalciform\tligament\tdivides\tthe\tleft\tlobe\tinto | [
0.05838479846715927,
-0.006815670058131218,
0.06894911825656891,
0.005414232611656189,
-0.11866246908903122,
-0.0043851579539477825,
0.07481403648853302,
-0.009371798485517502,
-0.01497606374323368,
0.07507210224866867,
0.10035966336727142,
-0.04787101969122887,
0.002822586102411151,
-0.00... |
visible\tfalciform\tligament\tdivides\tthe\tleft\tlobe\tinto\nthe\tmedial\tand\tlateral\tsegments.\tThe\tliver\tis\tsupplied\twith\tblood\tfrom\ttwo\tsources:\tthe\thepatic\tartery,\twhich\tsupplies\napproximately\tone\tthird\tof\tthe\tblood\tfrom\tthe\taorta;\tand\tthe\tportal\tvein,\twhich\tsupplies\tthe\tother\ttwo\... | [
0.019486363977193832,
-0.03918863460421562,
0.056361038237810135,
-0.008285067044198513,
-0.0828024223446846,
0.010453914292156696,
0.06672307848930359,
0.013611938804388046,
-0.014854629524052143,
0.03693188354372978,
0.1211751401424408,
-0.051574867218732834,
0.02831776812672615,
0.01241... |
collects\tblood\tdrained\tfrom\tthe\tdigestive\ttract.\nApproximately\t1500\tmL\tof\tblood\tper\tminute\tcirculates\tthrough\n\tthe\tliver\tand\texits\tvia\tthe\tright\tand\tleft\thepatic\nveins\tinto\tthe\tinferior\tvena\tcava.\tThe\tliver\thas\ta\tsystem\tof\tblood\tvessels\tand\ta\tseries\tof\tbile\tducts.\t\nBile\n... | [
0.0013196771033108234,
-0.020323319360613823,
0.002594904974102974,
-0.01356083806604147,
-0.08033571392297745,
-0.035509247332811356,
0.07746123522520065,
0.037705764174461365,
-0.0016081486828625202,
0.03183583915233612,
0.08586772531270981,
-0.06366380304098129,
0.035351186990737915,
0.... |
Bile\n,\twhich\tis\nformed\tin\tthe\tliver\tcells,\texits\tthe\tliver\tthrough\ta\tseries\tof\tbile\tducts\tthat\tincrease\tin\tsize\tas\tthey\tapproach\tthe\ncommon\tbile\tduct.\tBile\tis\ta\tthick,\tviscous\tfluid\tsecreted\tfrom\tthe\tliver,\tstored\tin\tthe\tgallbladder,\tand\treleased\n\tinto\tthe | [
0.06116907671093941,
-0.10487035661935806,
0.054618485271930695,
-0.041124481707811356,
-0.1670263409614563,
-0.05237787216901779,
0.061466291546821594,
0.020812924951314926,
0.011895643547177315,
0.026186970993876457,
0.09649758040904999,
-0.022244637832045555,
0.017228974029421806,
0.002... |
into\tthe\nduodenum\twhen\tfatty\tfoods\tenter\tthe\tduodenum.\tIt\temulsifies\tfats\tin\tthe\tintestine\tand\tforms\tcompounds\twith\tfatty\nacids\tto\tfacilitate\ttheir\tabsorption.\nFunctions\nThe\tliver\thas\tthe\tability\tto\tregenerate\titself.\tOnly\t10%\tto\t20%\tof\tfunctioning\tliver\tis\trequired\tto\tsustai... | [
0.04289081692695618,
-0.07727137953042984,
0.021469416096806526,
-0.032882172614336014,
-0.12026582658290863,
0.002600478706881404,
0.1240566074848175,
0.014892484992742538,
0.01721792481839657,
0.060272980481386185,
0.09865051507949829,
-0.047522228211164474,
0.06066184490919113,
0.022901... |
removal\tof\tthe\tliver\tresults\tin\tdeath,\tusually\twithin\t24\thours.\tThe\tliver\tis\tintegral\tto\tmost\tmetabolic\n\tfunctions\tof\tthe\nbody\tand\tperforms\tmore\tthan\t500\ttasks.\tThe\tmain\tfunctions\tof\tthe\tliver\tinclude\t(1)\tmetabolism\tof\tcarbohydrate,\nprotein,\tand\tfat;\t(2)\tstorage\tand\tactivat... | [
-0.013123932294547558,
-0.01947113312780857,
0.03524160757660866,
-0.03763027489185333,
-0.07649023830890656,
-0.023508429527282715,
0.10646605491638184,
-0.015164855867624283,
-0.01658763363957405,
0.04085642471909523,
0.08480057120323181,
0.00014445913257077336,
0.06746065616607666,
-0.0... |
conversion\tof\tammonia\tto\turea;\t(5)\tmetabolism\tof\tsteroid\thormones;\t(6)\tdetoxification\tof\tsubstances\tsuch\tas\tdrugs,\nalcohol,\tand\torganic\tcompounds;\tand\t(7)\n\tacting\tas\ta\tfilter\tand\tflood\tchamber.\nThe\tliver\tplays\ta\tmajor\trole\tin\tcarbohydrate\tmetabolism.\tGalactose\tand\tfructose,\tpr... | [
-0.020540714263916016,
-0.09531265497207642,
0.011108234524726868,
-0.03846020996570587,
-0.04733804613351822,
0.03250052407383919,
0.054414037615060806,
0.03437201306223869,
0.017306607216596603,
0.04303886741399765,
0.06867308914661407,
-0.06665852665901184,
-0.012291194871068,
0.0168305... |
digestion,\tare\tconverted\tinto\tglucose\tin\tthe\thepatocyte\t(liver\tcell).\tThe\tliver\tstores\tglucose\tas\tglycogen\n(glycogenesis)\tand\tthen\treturns\tit\tto\tthe\tblood\twhen\tglucose\tlevels\tbecome\tlow\t(glycogenolysis).\tThe\tliver\talso\nproduces\t“new”\tglucose\t(gluconeogenesis)\n\tfrom\tprecursors\tsuc... | [
-0.014049317687749863,
-0.08027133345603943,
0.050194621086120605,
0.005561924073845148,
-0.10209603607654572,
-0.03529512137174606,
0.055017516016960144,
0.0056328363716602325,
-0.020430229604244232,
0.043334003537893295,
0.10581741482019424,
-0.0320415198802948,
-0.038792684674263,
-0.02... |
from\tprecursors\tsuch\tas\tlactic\tacid,\tglycogenic\tamino\tacids,\tand\nintermediates\tof\tthe\ttricarboxylic\tacid\t(TCA)\tcycle.\nImportant\tprotein\tmetabolic\tpathways\toccur\tin\tthe\tliver.\t\nTransamination\n\t(transfer\tof\tan\tamino\tgroup\tfrom\tone\ncompound\tto\tanother)\tand\t\noxidative\tdeamination\n\... | [
-0.0029774277936667204,
-0.044858627021312714,
0.048539020121097565,
-0.04546915739774704,
-0.09937696158885956,
-0.00764351524412632,
0.08390244841575623,
-0.021696290001273155,
0.02945110946893692,
0.06247358396649361,
0.1130034327507019,
-0.015191914513707161,
0.06532204151153564,
0.036... |
(removal\tof\tan\tamino\tgroup\tfrom\tan\tamino\tacid\tor\tother\ncompound)\tare\ttwo\tsuch\tpathways\tthat\tconvert\tamino\tacids\tto\tsubstrates\n\tthat\tare\tused\tin\tenergy\tand\tglucose\nproduction\tas\twell\tas\tin\tthe\tsynthesis\tof\tnonessential\tamino\tacids.\tBlood-clotting\tfactors\tsuch\tas\tfibrinogen\ta... | [
-0.003026259131729603,
-0.024382520467042923,
0.07526563107967377,
-0.03505204990506172,
-0.03040175884962082,
0.018670441582798958,
0.09379702061414719,
-0.0027619418688118458,
-0.016054637730121613,
0.06313338875770569,
0.1290932446718216,
-0.04457024857401848,
0.02242412231862545,
0.059... |
prothrombin,\tas\twell\tas\tserum\tproteins\tincluding\talbumin,\talpha-globulin,\tbeta-globulin,\ttransferrin,\tceruloplasmin,\nand\tlipoproteins,\tare\tformed\tby\tthe\tliver.\nFatty\tacids\tfrom\tthe\tdiet\tand\tadipose\ttissue\tare\tconverted\tin\tthe\tliver\tto\tacetyl-coenzyme\n\tA\tby\tthe\tprocess\tof\tbeta- | [
-0.03868979960680008,
-0.09851304441690445,
-0.006698518060147762,
-0.04389839246869087,
-0.1077987402677536,
-0.010795398615300655,
0.05251447856426239,
0.059868309646844864,
0.0044320737943053246,
0.04511713236570358,
0.10114790499210358,
0.010473761707544327,
0.01976126991212368,
0.0413... |
A\tby\tthe\tprocess\tof\tbeta-\noxidation\tto\tproduce\tenergy.\tKetones\talso\tare\tproduced.\tThe\tliver\tsynthesizes\tand\thydrolyzes\ttriglycerides,\nphospholipids,\tcholesterol,\tand\tlipoproteins\tas\twell.\nThe\tliver\tis\tinvolved\tin\tthe\tstorage,\tactivation,\tand\ttransport\tof\tmany\tvitamins\tand\tmineral... | [
-0.027753237634897232,
-0.06495072692632675,
0.017292918637394905,
-0.023698579519987106,
-0.09319501370191574,
0.012957933358848095,
0.073360875248909,
0.043264128267765045,
-0.03127213567495346,
0.031675681471824646,
0.1256321370601654,
-0.040240347385406494,
0.014162859879434109,
0.0074... |
soluble\tvitamins\tin\taddition\tto\tvitamin\tB\n12\n\tand\tthe\tminerals\tzinc,\tiron,\tcopper,\tand\tmanganese.\n\tHepatically\nsynthesized\tproteins\ttransport\tvitamin\tA\t(retinol\tbinding\tprotein),\tiron\t(transferrin),\tzinc\t(metallothionein),\tand\ncopper\t(ceruloplasmin)\tin\tthe\tbloodstream.\tCarotene\tis\... | [
-0.04003551974892616,
-0.07964973896741867,
0.007409881334751844,
-0.008859501220285892,
0.01644536852836609,
0.052863363176584244,
0.038915835320949554,
0.09489583969116211,
-0.04492337629199028,
0.010733941569924355,
0.10676930844783783,
-0.024347728118300438,
0.04821665957570076,
0.0602... |
acid,\tand\tvitamin\tD\tto\tan\tactive\tform\t(25-hydroxycholecalciferol,\tcalcitriol)\tby\tthe\tliver.\nIn\taddition\tto\tfunctions\tof\tnutrient\tmetabolism\tand\tstorage,\n\tthe\tliver\tforms\tand\texcretes\tbile.\tBile\tsalts\tare\nmetabolized\tand\tused\tfor\tthe\tdigestion\tand\tabsorption\tof\tfats\tand\tfat-sol... | [
0.014598802663385868,
-0.10327782481908798,
0.025306908413767815,
0.0064132241532206535,
-0.020851323381066322,
0.04167569428682327,
0.058367542922496796,
0.06998557597398758,
-0.0159476175904274,
-0.026861613616347313,
0.09171942621469498,
-0.008724368177354336,
0.04931659623980522,
0.003... |
product\tfrom\tred\tblood\tcell\tdestruction;\tit\tis\tconjugated\tand\texcreted\tin\tthe\tbile.\nHepatocytes\tdetoxify\tammonia\tby\tconverting\tit\tto\turea,\t75%\tof\twhich\tis\texcreted\tby\tthe\tkidneys.\tThe\tremaining\nurea\tfinds\tits\tway\tback\tto\tthe\tgastrointestinal\n\ttract\t(GIT).\tThe\tliver\talso\tmet... | [
0.009301668033003807,
-0.12102679908275604,
0.022187896072864532,
-0.0350206084549427,
-0.09713809192180634,
-0.007475558202713728,
0.1185501292347908,
0.07508932054042816,
-0.017249606549739838,
0.05842282995581627,
0.11643986403942108,
0.006647265050560236,
0.04846751317381859,
0.0399314... |
and\texcretes\taldosterone,\tglucocorticoids,\testrogen,\tprogesterone,\tand\ttestosterone.\tIt\tis\tresponsible\tfor\tthe\ndetoxification\n\tof\tsubstances,\tincluding\tdrugs\tand\talcohol,\tas\twell\tas\ttoxins\tsuch\tas\tpollutants,\tchemicals,\tpesticides\nand\therbicides,\tbioactive\tcompounds,\tand\tbiological\tp... | [
0.021305469796061516,
-0.04744758829474449,
0.014191241934895515,
0.011925292201340199,
-0.03342187777161598,
0.01657099463045597,
0.10834890604019165,
0.02196013741195202,
-0.01749941147863865,
0.06876195967197418,
0.1290571689605713,
-0.007397815119475126,
0.03728504851460457,
0.01318632... |
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