How do you nutritionally manage high output enterocutaneous fistula?

How do you nutritionally manage high output enterocutaneous fistula?

(1999) recommended a starting point with 20–30 kcal/kg/day of non-protein calories, and 1.5–2.5 g/kg/day of protein. In high output fistula, 1.5–2 times of the usual calories were needed and vitamins and the trace elements recommended must be five to ten times the daily allowance (41).

What is the definitive treatment for enterocutaneous fistula?

Treatment. If the enterocutaneous fistula (ECF) doesn’t heal on its own after a few weeks or months, a complex surgery is required to close the fistula and reconnect the gastrointestinal tract. Patients with ECFs often need specialized wound care, nutritional rehabilitation and physical rehabilitation.

How can I reduce my fistula output?

An animal study has, however, found an 81% reduction in fistula output with an elemental diet compared with a regular diet and showed that intravenous nutrition reduced the output by 93%. Concomitantly, there were 71% fewer calories lost with enteral nutrition and 93% fewer with intravenous nutrition.

Which is a common cause of enterocutaneous fistula?

As previously mentioned, the most common cause of an enterocutaneous fistula is iatrogenic and occurs in the postoperative period. A history of trauma, inflammatory bowel disease, and oncologic surgery places patients at a high risk of developing a fistula.

Can you eat with an enterocutaneous fistula?

According to the patient’s ability to tolerate feeding, the maximum infusion rate can reach 120 ml/h per day. It is also important to avoid constipation and distal intestinal obstruction. Therefore, a balance must be achieved between slowing fistula output and avoiding constipation.

What is enterocutaneous fistula takedown?

An enterocutaneous fistula (ECF) is an abnormal connection that develops between the intestinal tract or stomach and the skin. As a result, contents of the stomach or intestines leak through to the skin. Most ECFs occur after bowel surgery.

What is high output enterocutaneous fistula?

An enterocutaneous (EC) fistula is referred to as a channel between the gut and the skin. Effluent of an EC fistula of more than 500 ml per day is considered as high output. Patients with high output EC fistulae have a high morbidity and mortality rate.

Which of the factors favors spontaneous closure of enterocutaneous fistula?

Favorable factors for spontaneous closure End fistulas (eg, those arising from leakage through a duodenal stump after Pólya gastrectomy) Jejunal fistulas. Colonic fistulas. Continuity-maintained fistulas – These allow the patient to pass stool.

When do you use enteral nutrition?

When Would a Patient Really Require Enteral Nutrition? When a patient has difficulty eating for whatever reason and when the GI tract is working, then using this natural means for feeding would be preferable to feeding by intravenous means. Using the GI tract is closer to normal and can help the immune system.

What are the side effects of TPN?

Possible complications associated with TPN include:

  • Dehydration and electrolyte Imbalances.
  • Thrombosis (blood clots)
  • Hyperglycemia (high blood sugars)
  • Hypoglycemia (low blood sugars)
  • Infection.
  • Liver Failure.
  • Micronutrient deficiencies (vitamin and minerals)

What is the most common complication of parenteral nutrition?

Fatty liver is the most common complication, whereas intrahepatic cholestasis or hepatitis are less frequent.

How do you manage a fecal fistula?

Conservative Therapy

  1. Rehydration.
  2. Administration of antibiotics.
  3. Correction of anemia.
  4. Electrolyte repletion.
  5. Drainage of obvious abscess.
  6. Nutritional support.
  7. Control of fistula drainage.
  8. Skin protection.

How do you treat an abdominal fistula?

Treatments may include:

  1. Antibiotics.
  2. Immune suppressing medicines if the fistula is a result of Crohn disease.
  3. Surgery to remove the fistula and part of the intestines if the fistula is not healing.
  4. Nutrition through a vein while the fistula heals (in some cases)

What is a high output enterocutaneous fistula?

Where is parenteral nutrition administered?

“Parenteral” means “outside of the digestive tract.” Whereas enteral nutrition is delivered through a tube to your stomach or the small intestine, parenteral nutrition bypasses your entire digestive system, from mouth to anus. Certain medical conditions may require parenteral nutrition for a short or longer time.