Here, you'll find news and announcements relating to our hospital, our staff, or the BCIR procedure.
- BCIR Seminar - September 9, 2012
- QLA Annual Conference - September 20-22, 2012
- Treatment for a Blockage
- Probiotics for Treatment of Chronic Pouchitis
- Dedication Day at Palms of Pasadena Hospital
Please join us for our next seminar about the Barnett Continent Intestinal Reservoir on Sunday, September 9, 2012, 1pm at the Jackson Marriott in Jackson, Mississippi.
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The 27th Annual Quality Life Association Conference will be held September 20-22, 2012 at the TradeWinds Resort in St. Petersburg, Florida. Plan to join us for a weekend of learning, fun and making new friends. See the Hotel reservation form on the QLA website. The final agenda will be forthcoming. You won't be disappointed if you attend!
For more information, visit qla-ostomy.org or contact Judy Schmidt at 352-394-4912 for a conference brochure. We look forward to seeing many of you for this fun and educational few days!
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There are several degrees of blockages which may include partial or complete, simple or complicated. Partial obstruction allows some liquid contents and gas to pass through the point of obstruction, whereas complete obstruction impedes passage of all bowel contents. Unlike simple obstruction, complicated obstruction indicates compromise of the circulation to a segment of bowel with resultant ischemia, infarction and possible perforation.
Symptoms of a complete blockage usually include discomfort with distention associated with nausea and vomiting. When you insert your catheter into your pouch, there is NO return of stool. Less severe symptoms can be indicative of a partial blockage.
Intervention is as follows:
- Try to relax.
- If there is output from your pouch and you are not nauseated or vomiting, take some sips of hot tea. Consume clear liquids until ALL your symptoms have passed.
- Take a warm tub bath or use a heating pad to relax your muscles.
- Turn, stretch, and gently massage the abdomen.
- If symptoms intensify and you begin to vomit and have no output for several hours, please go to your nearest emergency room and encourage them to contact your BCIR surgeon.
- If your catheter is not indwelling already, don't forget to take your catheter and any other supplies or information that you may need.
- When you are seen in the ER, one of the first anticipated tests should be a CT scan with contrast. We recommend that you get this test done with your catheter in place (plugged) so your health care team can better define your anatomy. Don't forget to alert the radiologist to the fact that you have a continent reservoir and they may need to wait longer than usual to do your scan, allowing time for the contrast to get to your pouch.
- After the x-ray, keep the catheter in place and ask staff to connect it to gravity drainage or intermittent suction. Remember: if you are using a Foley-type catheter, never let the hospital staff inflate the balloon on the end.
- People without a large colon tend to dehydrate easily. You should anticipate intravenous fluids being started. Pain medication will probably be administered. Sometimes this helps the muscles relax and the obstruction improve.
- With this conservative care, it is the hope that the obstruction will clear.
- In some cases, it does not, and placement of a nasogastric tube in your nose is necessary along with the BCIR catheter. If this does not resolve your issue, surgical intervention may be necessary.
We do hope to maintain a relationship with you over the long term so you are not alone. Stay in contact with your BCIR surgeon and staff.
Ernest Rehnke, M.D.
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For many, the most common problem after a BCIR is pouchitis, which is the development of recurrent mucosal inflammation within the pouch. The etiology and pathophysiology of pouchitis are not well understood but it likely results from an interaction between a patient who is genetically susceptible and the small bowel mucosa which is exposed to fecal stasis (retention) and bacterial over growth.
Episodes of pouchitis may be acute and intermittent or chronic and unremitting. Antibiotics continue to be the treatment for acute and intermittent pouchitis while oral administration of probiotics for some has been effective in the prevention of relapses in individuals with chronic pouchitis. As our knowledge and experience with probiotics continues to increase, we want to share this information with you.
People normally have large numbers of a wide variety of bacteria on their skin, in their mouth, nose, vagina and in their large intestine or colon. Each individual's pattern is unique relative to the type and percentage of individual bacteria. Bacterial patterns can be altered by changes in diet, environment and antibiotic usage. It also can be changed when the colon is removed. Continent pouches store stool, which allows the growth of bacteria, but it is a new pattern of bacteria. This new pattern can be problematic for some.
Probiotics are dietary supplements of live microorganisms which when administered in adequate amounts, may provide a health benefit. It is felt that it improves the intestinal microbial balance. Documented studies have shown alleviation of chronic intestinal inflammatory disease, i.e. pouchitis.
There are many probioitics on the market today with various bacterial types and counts. What is good for one is not necessarily good for others. Up until recently, all probiotics have been considered over the counter supplements with various out of pocket expenses. This expense alone has prohibited some from considering this option. Most recently prescription strength has become available and as a result some of the insurance plans are providing benefits. The prescription brand is called VSL#3 Double Strength. We are not indicating that this is the only brand to use but we are very excited that for some, there will be coverage. Before requesting a prescription, you should contact your drug plan to see if this is an option. If so, your local health care provider should be able to provide you with a prescription or as always we are available.
Ernest Rehnke, M.D.
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On November 14, 2007, a new 17 bed Unit was dedicated at Palms of Pasadena Hospital for BCIR patients. The dedication was attended by many of our BCIR alumni as well as local community leaders and medical staff.
This unit represents larger rooms with more closet and additional storage space. Each room has both green furnishings and wallpaper to create a calming and restful environment for the patient and their guest.
The transition to the new unit has been easy, as the staff has remained consistent!
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