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Surgical Mgt of IBD (Typical procedures (Stoma (Ileostomy (Opening from SI…

- - - - Opening from SI (ileum) - usually on right hand side
        
        May be:
        
        Loop - temporary
        
        End - permanent
    - - Stoma from LI
        
        Descending
        
        Sigmoidal
        
        Transcending
        
        Ascending
  - - - Illeal
      - Ileocolonic
  - - - Reversal of ileostomy
        
        Continuity of bowel is re-established w J-Pouch
      - Total/subtotal colectomy + Formation of IPAA (Ileal Pouch Anal Anastomosis)
        
        Creates a neorectal reservoir to:
        
        Reduce urgency of bowel movements
        
        Reduce nocturnal bowel movements
        
        Reduce frequency of bowel movements
        
        J-Pouch from 20-25cm of ileum
        
        Pt given temporary ileostomy
- - - - As per stoma plus if nocturnal B/O change main meal to lunchtime
  - - - Thick output - check hydration status
      - Inc output
        
        Spicy food
        
        Caffeine
        
        Prune juice
        
        Alcohol
        
        Metamucil/Loperamide may thicken & slow output
      - Inc gas
        
        Carbonated drinks
        
        Spicy foods
        
        Cabbage, broccoli, peas, asparagus, onion
      - Inc odour
        
        Fish, onion, eggs
        
        Yoghurt, parsley may help