Liver Disorders, Pancreatic Insufficiency, Short Bowel Syndrome and Stoma Care

Question 1

What is cholestasis?
What are the symptoms?

Answer 1

Impaired bile formation or flow
- puritis (itchiness)
- dark urine
- jaundice

Question 2

How can cholestatic puritus be treated?

Answer 2

Cholestyramine
Rifampicin
Ursodeoxycholic acid

Question 3

What are gallstones?

Answer 3

Hard mineral or fatty deposits that cause stones in gallbladder bile ducts

Question 4

Treatment of gallstones

Answer 4

1. Surgically removed
2. Pain management- paracetamol and NSAIDs or IM Diclofenac

Question 5

What is pancreatic Insufficiency?

Answer 5

Reduced secretion of pancreatic enzymes into the duodenum due to conditions such as
- CF
- Coeliac disease
- pancreatitis

Question 6

How is pancreatic insufficiency treated?

Answer 6

Pancreatin- pancreatic enzyme replacement
- this contains lipase, amylase and protease which help to digest food so it can be absorbed
- take with meals

Question 7

What is short bowel syndrome?

Answer 7

Shortened bowel due to large surgical resection
- MUST ensure adequate absorption of nutrients and fluids

Question 8

Which nutritional deficiency must be replaced in those with short bowel syndrome?

Answer 8

Replace vitamin A, B12, D, E and K
As well as fatty acids, zinc and selenium

Question 9

What can be used to help diarrhoea/ reduce output into stoma?

Answer 9

Loperamide and codeine to reduce intestinal motility

Question 10

What is a stoma?

Answer 10

An artificial opening of the abdomen to divert the flow of faeces or urine into an external pouch

Question 11

Can you use an enteric coating or modified release capsule if someone has a stoma?

Answer 11

NO
- use forms with quick actions such as liquids, capsules and uncoated tablets