Effects of Small Bowel Resection

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Vitamins are energy building nutrients that contribute to sound nutritional health. Water, on the other hand, is responsible for carrying necessary nutrients and removing waste products throughout our body. A human body is made out of mostly water and is critical to our health. Similarly, minerals and electrolytes are essential to human health and can be obtained in our diet from different foods. When humans are too sick to consume a regular diet, digestion and absorption may impact the supply of necessary nutrients, requiring specialized nutritional support to meet their nutritional needs.

After studying Module 4: Lecture Materials & Resources, read the case study and answer the prompts:

Sharyn Bartell is a 24-year-old student who suffered multiple fractures when she fell from a cliff when hiking. As a result of the accident, she is immobile, in traction, and had a small bowel resection. She is able to keep her head up to 45 degrees. Sharyn used to weigh 140 pounds but has lost 8 pounds since the accident. The healthcare team agrees that Sharyn will need a feeding tube before her nutritional status deteriorates any further.

  1. Navigate the web, research a high protein formula that can be administered via feeding tube and share 1) name of formula, 2) nutrient composition, and 3) indications for use.
  2. Navigate to the Oley Foundation: Dietary Recommendations for Patients with Intestinal Failure – Oley FoundationLinks to an external site., read “Physiological Considerations” and discuss in at least one paragraph with two (2) effects of the small bowel resection on Sharyn’s fluid and electrolyte balance.
  3. Navigate to the Oley Foundation: Living with Enteral Feeds – Oley FoundationLinks to an external site. and provide two (2) physical or psychosocial adjustments Sharyn will have to make when living with a feeding tube.

Your initial post should be at least 400 words, formatted, and cited in the current APA style with support from the textbook and sources provide

effects of small bowel resection

Case Study: Nutritional Support for Sharyn Bartell

Sharyn Bartell, a 24-year-old student, has sustained multiple fractures and a small bowel resection following a fall from a cliff. Due to her current immobility and inability to maintain adequate nutritional intake, the healthcare team has decided to implement a feeding tube to prevent further nutritional deterioration. This post will address the appropriate high-protein formula for Sharyn, the effects of small bowel resection on fluid and electrolyte balance, and the adjustments she will need to make living with a feeding tube.

High-Protein Formula for Enteral Feeding

Formula Name: Jevity 1.2 Cal

  1. Nutrient Composition:
    • Calories: 1.2 calories per mL
    • Protein: 18.5 grams per 8 oz (250 mL)
    • Carbohydrates: 37.5 grams per 8 oz
    • Fat: 9.9 grams per 8 oz
    • Fiber: 4.7 grams per 8 oz
    • Vitamins and Minerals: Contains a comprehensive blend of essential vitamins and minerals including vitamin A, vitamin D, vitamin E, vitamin K, vitamin C, thiamine, riboflavin, niacin, vitamin B6, folic acid, vitamin B12, biotin, pantothenic acid, calcium, phosphorus, magnesium, zinc, manganese, copper, iodine, selenium, and chromium.
  2. Indications for Use:
    • Patients with increased protein needs, such as those with wounds, trauma, or after surgery
    • Individuals requiring long-term tube feeding who need a high-protein, high-calorie formula
    • Suitable for patients with normal or elevated calorie needs and those who need a concentrated source of nutrition

Effects of Small Bowel Resection on Fluid and Electrolyte Balance

According to the Oley Foundation’s recommendations for patients with intestinal failure, a small bowel resection can significantly impact fluid and electrolyte balance due to the reduced surface area for nutrient and water absorption. Two major effects include:

  1. Dehydration:
    • The small bowel plays a crucial role in water absorption. After a resection, the remaining bowel may not be able to absorb sufficient water, leading to increased risk of dehydration. Sharyn will need careful monitoring of her fluid intake and may require additional hydration through intravenous fluids or increased enteral water flushes to maintain adequate hydration levels.
  2. Electrolyte Imbalance:
    • Electrolytes such as sodium, potassium, calcium, and magnesium are absorbed in the small intestine. Post-resection, the reduced absorption area can lead to deficiencies or imbalances in these electrolytes. This may cause symptoms such as muscle cramps, fatigue, and cardiac irregularities. Regular blood tests and tailored supplementation will be necessary to manage and correct these imbalances.

Adjustments Living with a Feeding Tube

Living with a feeding tube requires both physical and psychosocial adjustments. According to the Oley Foundation, two significant adjustments Sharyn will need to make include:

  1. Physical Adjustments:
    • Sharyn will need to adapt to the physical presence of the feeding tube, which includes learning how to manage and care for the tube site to prevent infections and complications. This involves routine cleaning, monitoring for signs of infection, and ensuring the tube is secure and functioning correctly. Additionally, she will need to adjust her daily activities to accommodate the feeding schedule and the equipment required for tube feeding.
  2. Psychosocial Adjustments:
    • Psychologically, Sharyn may experience changes in her body image and self-esteem due to the visible presence of the feeding tube. Social interactions may be affected as she adjusts to feeding in social settings or explaining her condition to others. She may also experience anxiety or depression related to her dependence on enteral nutrition and the changes in her lifestyle. Support from healthcare providers, counselors, and support groups will be essential to help her navigate these challenges and maintain a positive outlook.

In conclusion, Sharyn Bartell’s condition necessitates a high-protein enteral formula like Jevity 1.2 Cal to meet her nutritional needs. The small bowel resection significantly impacts her fluid and electrolyte balance, requiring careful monitoring and management. Additionally, Sharyn will need to make various physical and psychosocial adjustments to adapt to life with a feeding tube. Proper support and education will be crucial in helping her maintain her health and quality of life.

References

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