Journal of The Association of Physicians of India

Journal of The Association of Physicians of India.

Free full text available from Volume 48, 2000 onwards to current. Apart from regular issues some special issues are also available.

http://www.japi.org/previous_issue.html

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Treating Ulcerative Colitis

Treating Ulcerative Colitis
By:Robert Theobald III, D.O.
Vein Associates, P.A.

Introduction
* Ulcerative colitis is a chronic inflammatory disease of unknown etiology
* Primarily affects the colon and rectum
* Lesions are characterized by superficial infiltration of the bowel wall by inflammatory white cells
* Results in mucosal ulcerations and crypt abscesses
History
Epidemiology
Clinical Presentation
Clinical Presentation Symptoms
Colitis Activity Assessment
Diagnosis
* The diagnosis of UC is based on the clinical picture, stool examination, colonoscopic appearance, and histologic assessment of biopsied specimens
* The differential diagnosis includes infectious, chemical, IBS, ischemia, and miscellaneous
Disease Distribution at Presentation
Current Pharmacotherapy
Fallingborg Study
Steroids
Immunomodulators
New Therapy for Treatment of UC
Natural Remedies

Treating Ulcerative Colitis.ppt

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Stoma Care Basics

Stoma Care Basics

Two basic types of diversions
* Urinary
* Fecal

Urinary Diversions
Reasons for diversions
* Removal of bladder from cancer
* Neurogenic bladder, congenital anomalies, strictures, trauma to the bladder, and chronic infections with deterioration of renal function

Types of diversions
* Incontinent
Ileal Conduit
Cutaneous ureterostomy
Nephrostomy
Continent Diversions
Kock Pouch
Indiana Pouch
Continent urinary diversions
Complications
* Breakdown of the anastomoses in the GI tract.
* Leakage from the ureteroileal or ureterosigmoid anastomosis
* Paralytic ileus
* Obstruction of ureters
* Wound infection
* Mucocutaneous separation
* Stomal necrosis
Wound infection
Mucocutaneous separation
Stomal necrosis
Nursing Management
* Pre-op Care
Postoperative Care
Stomal prolapse
Bowel Diversions
Colostomies
Ileostomy
Surgical interventions
Loop stoma
End Stoma
End stoma with Hartmann’s pouch
Double-barrel stoma
Continent fecal diversions
Ileoanal reservoir
Kock Pouch
Special considerations for patients who have ileoanal reservoirs
Nursing Management- preoperative
More to consider pre-op
More post op considerations:
Good stoma Bad stoma
More about stomas
What about pouching?
What do we need to observe and document?
What about eating?
What to avoid
Other food issues you need to know about
Management options for permanent descending colostomy
One and two piece units
Ileostomy care
Protect the skin!
Important to know
More to know
Patient Teaching
Managing odor
When you teach ostomy care
Routine Skin Care
Cleansing
Shaving
More considerations
Adaptation to a stoma

Stoma Care Basics.ppt

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