Management of Intestinal Failure: The High-Output Enterostomy and Enterocutaneous Fistula

Overview

Journal Clin Colon Rectal Surg

Date 2017 Jul 8

PMID 28684940

Citations 9

Authors

Franklin Adaba

Carolynne J Vaizey

Janindra Warusavitarne

Affiliations

Soon will be listed here.

Abstract

This article provides an overview of the pathophysiology, causes, investigations, and management of high-output enterostomy and enterocutaneous fistula. High-output stoma and enterocutaneous fistula can result in intestinal failure and this is often fatal if not managed properly. The management involves reducing fluid losses, providing nutrients with fluids, and treating the underlying cause and sepsis. A multidisciplinary approach is required for successful management of patients with high-output enterostomy and enterocutaneous fistula.

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References

Farthing M . Octreotide in dumping and short bowel syndromes. Digestion. 1993; 54 Suppl 1:47-52. DOI: 10.1159/000201077. View

Scott N, Leinhardt D, OHanrahan T, Finnegan S, Shaffer J, Irving M . Spectrum of intestinal failure in a specialised unit. Lancet. 1991; 337(8739):471-3. DOI: 10.1016/0140-6736(91)93403-v. View

Jeppesen P . Teduglutide, a novel glucagon-like peptide 2 analog, in the treatment of patients with short bowel syndrome. Therap Adv Gastroenterol. 2012; 5(3):159-71. PMC: 3342570. DOI: 10.1177/1756283X11436318. View

Nightingale J, Lennard-Jones J, Walker E, Farthing M . Jejunal efflux in short bowel syndrome. Lancet. 1990; 336(8718):765-8. DOI: 10.1016/0140-6736(90)93238-k. View

Reber H, Roberts C, Way L, Dunphy J . Management of external gastrointestinal fistulas. Ann Surg. 1978; 188(4):460-7. PMC: 1396834. DOI: 10.1097/00000658-197810000-00003. View

Coetzee E, Rahim Z, Boutall A, Goldberg P . Refeeding enteroclysis as an alternative to parenteral nutrition for enteric fistula. Colorectal Dis. 2014; 16(10):823-30. DOI: 10.1111/codi.12727. View

Slater R . High-output stomas: challenges with a large laparostomy wound. Br J Nurs. 2012; 21(6):S26, S28-33. DOI: 10.12968/bjon.2012.21.Sup6.S26. View

Nightingale J . The medical management of intestinal failure: methods to reduce the severity. Proc Nutr Soc. 2003; 62(3):703-10. DOI: 10.1079/PNS2003283. View

Braunschweig C, Levy P, Sheean P, Wang X . Enteral compared with parenteral nutrition: a meta-analysis. Am J Clin Nutr. 2001; 74(4):534-42. DOI: 10.1093/ajcn/74.4.534. View

10.

Arebi N, Forbes A . High-output fistula. Clin Colon Rectal Surg. 2009; 17(2):89-98. PMC: 2780049. DOI: 10.1055/s-2004-828655. View

11.

Sundaram A, Koutkia P, Apovian C . Nutritional management of short bowel syndrome in adults. J Clin Gastroenterol. 2002; 34(3):207-20. DOI: 10.1097/00004836-200203000-00003. View

12.

Teubner A, Morrison K, Ravishankar H, Anderson I, Scott N, Carlson G . Fistuloclysis can successfully replace parenteral feeding in the nutritional support of patients with enterocutaneous fistula. Br J Surg. 2004; 91(5):625-31. DOI: 10.1002/bjs.4520. View

13.

Baker M, Williams R, Nightingale J . Causes and management of a high-output stoma. Colorectal Dis. 2009; 13(2):191-7. DOI: 10.1111/j.1463-1318.2009.02107.x. View

14.

Medlin S . Nutritional and fluid requirements: high-output stomas. Br J Nurs. 2012; 21(6):S22-5. DOI: 10.12968/bjon.2012.21.Sup6.S22. View

15.

Jeppesen P, Staun M, Tjellesen L, Mortensen P . Effect of intravenous ranitidine and omeprazole on intestinal absorption of water, sodium, and macronutrients in patients with intestinal resection. Gut. 1998; 43(6):763-9. PMC: 1727363. DOI: 10.1136/gut.43.6.763. View

16.

Naberhuis J, Tappenden K . Teduglutide for Safe Reduction of Parenteral Nutrient and/or Fluid Requirements in Adults: A Systematic Review. JPEN J Parenter Enteral Nutr. 2015; 40(8):1096-1105. DOI: 10.1177/0148607115582063. View

17.

Lal S, Teubner A, Shaffer J . Review article: intestinal failure. Aliment Pharmacol Ther. 2006; 24(1):19-31. DOI: 10.1111/j.1365-2036.2006.02941.x. View

18.

Ferrone M, Scolapio J . Teduglutide for the treatment of short bowel syndrome. Ann Pharmacother. 2006; 40(6):1105-9. DOI: 10.1345/aph.1G419. View

19.

Winkler M, Smith C . Clinical, social, and economic impacts of home parenteral nutrition dependence in short bowel syndrome. JPEN J Parenter Enteral Nutr. 2014; 38(1 Suppl):32S-37S. DOI: 10.1177/0148607113517717. View

20.

Jeppesen P, Lund P, Gottschalck I, Nielsen H, Holst J, Mortensen J . Short bowel patients treated for two years with glucagon-like peptide 2 (GLP-2): compliance, safety, and effects on quality of life. Gastroenterol Res Pract. 2009; 2009:425759. PMC: 2706978. DOI: 10.1155/2009/425759. View