Cal needs w/ enteral & high ostomy output

[Guest guest]

I am fowarding this question from a friend and fellow RD. Thanks, in advance, for your help! need helpWhat is your interpretation of high ileostomy output. I have a patient. Hx gastrci by pass gone wrong. Now with ileostomy and Tf running into her remnent stomach. She was on TPN because Surgeon said she is malabsorbing. Pt just came to me about a week ago. Admit weight 103lb. Current weight 132 with a lot of edema. Albumin as low as 2 at one point now up to 3.2 awaitng prealbumi...CRP high at

5.1 awaiting d-xylose ileostomy output anywhere from 900 to 1700 per day. Medicine is technically in charge of case but surgeon...you know the one who won't listen. keeps coming to talk to patient and telling her she needs 2500kcals a day...2000 from tf because she is malabsorbing everything. erin and i (and medicine)have a hard time believing she is really malabsorbing with an improvement in wieght(despite fluid) and improvement in albumin even in an inflamed state. we do not feel she needs that many kcals but she is FURIOUS because the surgeon tells her she is. thoughts to help me get a some other thoughts besides my own going

Be a better friend, newshound, and know-it-all with Mobile. Try it now.