Ileostomy Clinical Trial
Official title:
The Effect of Ileostomy Formation on Nutritional Status and Electrolyte Profile in Rectosigmoidectomy Patients: a Prospective Randomized Trial.
One of the main reasons for hospital readmission in ileostomy patients is fluid and
electrolyte abnormalities. Prospective observational studies have suggested an occurrence
rate of around 20%. Due to colonic exclusion ileostomy patients lose large amounts of sodium
and fluid through their stoma effluent. In addition studies have shown that ileostomy
construction is a risk factor for renal impairment, occurring secondary to dehydration.
Encouraging patients to increase total fluid intake seems to be a common mistake in clinical
practice as this can dilute sodium levels even more, causing greater sodium depletion. In
terms of addressing the problem a few small studies have used isotonic drinks of various
compositions showing increased electrolyte absorption.
Other dietary complications sometimes include hypomagnesaemia and decreased absorption of
B-12 and folic acid, however due to the integrity of the small intestine other nutrient
malabsorption is unlikely to occur. As far as body composition is concerned obesity has been
shown to be a risk factor for peri- and postoperative complications in colorectal surgery
(e.g. peristomal dermatitis, stoma stenosis and prolapse). A prospective trial examining
measures that can prevent readmission for dehydration and other nutritional considerations
related to this group of patients is definitely required.
Hypothesis:
The administration of an oral rehydration solution will allow a significant decrease in
dehydration and electrolyte abnormality rates in patients with a temporary ileostomy.
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