2004 Research: Colostomy, Ileostomy and Ileoanal Reservoir Surgery

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1. How Do J-Pouches Work?
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.
Year Published (YR): 2004.
Audience code (AC): PATIENT (400).
Author (AU): Church, J.
Source (SO): Ostomy Quarterly. 41(2): 49. Winter 2004.
Abstract (AB): Continent bowel diversions are made by creating internal pouches, or reservoirs. Pouches created in the pelvic area (j-pouch, pull-through) are ‘reconnected’ to allow the normal route of evacuation. This brief article helps readers understand how j-pouches work. The author reviews the normal physiology of the small intestine and colon to describe why the pouch is so vital (to store and concentrate stool). The author explains peristalsis (of the small intestine) and the process of elimination by gravity rather than with the muscles of the rectum. Practical toileting strategies are also provided. 1 figure.

Major Descriptors (MJ): Digestive System Diseases. Diarrhea. Ileal Pouch. Continent Ileostomy. Complications. Etiology. Patient Care Management.
Minor Descriptors (MN): Defecation. Patient Education. Physiology. Small Intestine. Colon. Rectum.
Verification/Update Date (VE): 200404.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 10070.
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2. Ileostomy and Its Alternatives.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Pemberton, J.H.; Phillips, S.F.
Source (SO): In: Feldman, M.; Friedman, L.S.; Sleisenger, M.H. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 2002. p. 2068-2079.
Availability (AV): Available from Elsevier. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 545-2522. Fax (800) 568-5136. Website: www.us.elsevierhealth.com. PRICE: $229.00 plus shipping and handling. ISBN: 0721689736.
Abstract (AB): Proctocolectomy and permanent ileostomy return most patients with chronic ulcerative colitis to excellent health and remove premalignant mucosa in patients with either chronic ulcerative colitis or familial adenomatous polyposis (FAP). Many of the former inconveniences and dangers associated with an ileal stoma have been eliminated by improved surgical techniques, a wider range of better stomal appliances, and more effective education of patients. This chapter on ileostomy and its alternatives is from a comprehensive and authoritative textbook that covers disorders of the gastrointestinal tract, biliary tree, pancreas, and liver, as well as the related topics of nutrition and peritoneal disorders. Topics include pathophysiologic consequences of proctocolectomy, including fecal output after proctocolectomy and functional sequelae; overall clinical consequences of proctocolectomy; complications and management of conventional ileostomies; continent ileostomy (Kock pouch); ileal pouch-anal anastomosis; abdominal colectomy and ileorectal anastomosis; colostomy in the management of inflammatory bowel disease (IBD); and a summary of risk-benefit analysis for each type of ileostomy. The chapter includes a mini-outline with page citations, illustrations, and extensive references. 3 figures. 2 tables. 75 references.
Major Descriptors (MJ): Digestive System Diseases. Gastroenterology. Patient Care Management. Ileostomy. Symptoms. Surgical Techniques.
Minor Descriptors (MN): Inflammatory Bowel Disease. Risk Factors. Professional Education. Pathology. Postoperative Complications. Prognosis. Surgery. Patient Selection. Physiology. Continent Ileostomy. Ileal Pouch. Fecal Incontinence.

Verification/Update Date (VE): 200310.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 09645.
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3. Your Colostomy.
Subfile: Digestive Diseases

Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Pritchett and Hull Associates, Inc.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 2 p.

Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: phsales@p-h.com. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 442.
Abstract (AB): A colostomy is done when the large intestine can no longer handle waste matter (stool) passing through it. The stool is rerouted around a diseased or damaged area of the colon, and a surgically created opening (a colostomy) is made. This patient education fact sheet helps patients understand colostomies and their care. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet describes colostomy and its indications, everyday activities with a colostomy, and the different types of colostomies (ascending, transverse, descending, and sigmoid). One section reviews practical strategies for patient self-care. 6 figures.
Major Descriptors (MJ): Digestive System Diseases. Stoma. Colostomy. Ostomy Supplies. Self Care.
Minor Descriptors (MN): Patient Education. Equipment and Supplies. Colon. Physiology. Surgical Techniques. Skin Care.
Verification/Update Date (VE): 200401.
Notes (NT): CP: Yes.

Accession Number (AN): DD DC 09903.
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4. Your Ileostomy.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.

Year Published (YR): 2002.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Pritchett and Hull Associates, Inc.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 2 p.
Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: phsales@p-h.com. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 443.
Abstract (AB): An ileostomy is a surgically created opening that allows waste to leave the body through the small intestine. Stool (waste) from an ileostomy will still be liquid. This patient education fact sheet helps patients understand ileostomies and their care. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet first reviews the anatomy and function of the digestive system. The fact sheet then describes ileostomy and its indications, and everyday activities with a ileostomy. One section reviews practical strategies for patient self-care. 3 figures.

Major Descriptors (MJ): Digestive System Diseases. Stoma. Ileostomy. Ostomy Supplies. Self Care.
Minor Descriptors (MN): Patient Education. Equipment and Supplies. Small Intestine. Physiology. Skin Care. Activities of Daily Living.
Verification/Update Date (VE): 200401.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 09905.
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5. Colostomy and Your Diet.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): PATIENT (400).

Corporate Author (CN): Pritchett and Hull Associates, Inc.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 2 p.
Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: phsales@p-h.com. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 440.
Abstract (AB): A colostomy is done when the large intestine can no longer handle waste matter (stool) passing through it. The stool is rerouted around a diseased or damaged area of the colon, and a surgically created opening (a colostomy) is made. This patient education fact sheet helps people with colostomies understand the importance of managing their diet. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet describes the interplay of diet and healthy colostomy care. Topics include the importance of eating a healthy and well-balanced diet, immediate postoperative dietary restrictions, coping with odor, the need for more fluids than before the colostomy, the need for sodium and potassium in the diet, and the role of exercise. One side of the fact sheet consists of a chart of different foods, categorized in four groups: foods that may cause gas, foods that may lead to constipation or thick stool, foods that may lead to diarrhea or loose stool, and foods that may cause odor. 2 figures.
Major Descriptors (MJ): Digestive System Diseases. Stoma. Colostomy. Diet. Food Habits.
Minor Descriptors (MN): Patient Education. Self Care. Diet Therapy. Flatulence. Prevention. Fluids. Vitamins. Minerals. Nutrition.

Verification/Update Date (VE): 200401.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 09906.
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6. Changing Your 1 Piece Ostomy Pouch.
Subfile: Digestive Diseases

Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Pritchett and Hull Associates, Inc.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 2 p.

Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: phsales@p-h.com. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 435.
Abstract (AB): This patient education fact sheet helps patients understand ostomy care, notably how to change a one-piece ostomy pouch. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet first introduces the recommended schedule for changing and reminds readers of the importance of good skin care to prevent infection. The fact sheet then offers helpful tips for changing the pouch and a list of the symptoms of skin irritation or infection. The reverse side of the fact sheet walks readers through the steps for changing the pouch. 3 figures.
Major Descriptors (MJ): Digestive System Diseases. Stoma. Colostomy. Ostomy Supplies. Self Care.
Minor Descriptors (MN): Patient Education. Equipment and Supplies. Colon. Physiology. Surgical Techniques. Skin Care. Symptoms. Infection.
Verification/Update Date (VE): 200401.
Notes (NT): CP: Yes.

Accession Number (AN): DD DC 09907.
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7. Emptying Your 1 Piece Pouch.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.

Year Published (YR): 2002.
Corporate Author (CN): Pritchett and Hull Associates, Inc.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 1 p.
Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: phsales@p-h.com. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 437.
Abstract (AB): This brief patient education fact sheet helps patients understand ostomy care, notably how to empty a one-piece ostomy pouch. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet first discusses how to know when to empty the pouch and then walks readers through the steps for emptying the pouch. Readers are encouraged to work closely with their health care provider to address any questions or concerns about caring for their ostomy. 3 figures.
Major Descriptors (MJ): Digestive System Diseases. Stoma. Colostomy. Ostomy Supplies. Self Care.

Minor Descriptors (MN): Patient Education. Equipment and Supplies. Defecation.
Verification/Update Date (VE): 200401.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 09908.
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8. Changing Your 2 Piece Ostomy Pouch.

Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).
Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Pritchett and Hull Associates, Inc.

Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 2 p.
Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: phsales@p-h.com. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 436.
Abstract (AB): This patient education fact sheet helps patients understand ostomy care, notably how to change a two-piece ostomy pouch. A two-piece pouch system has a skin barrier wafer or flange and a snap-on pouch. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet first introduces the recommended schedule for changing and reminds readers of the importance of good skin care to prevent infection. The fact sheet then offers helpful tips for changing the pouch and a list of the symptoms of skin irritation or infection. The reverse side of the fact sheet walks readers through the steps for changing the pouch. 2 figures.
Major Descriptors (MJ): Digestive System Diseases. Stoma. Colostomy. Ostomy Supplies. Self Care.
Minor Descriptors (MN): Patient Education. Equipment and Supplies. Colon. Physiology. Surgical Techniques. Skin Care. Symptoms. Infection.
Verification/Update Date (VE): 200401.

Notes (NT): CP: Yes.
Accession Number (AN): DD DC 09909.
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9. Emptying Your 2 Piece Pouch.
Subfile: Digestive Diseases
Format (FM): FACTSHEET (22).

Language(s) (LG): English.
Year Published (YR): 2002.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Pritchett and Hull Associates, Inc.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 2002 2 p.
Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340-3079. (770) 451-0602 or (800) 241-4925. Fax (800) 752-0510. Website: www.p-h.com. Email: phsales@p-h.com. PRICE: Sample copy available online at no charge; $10.50 for tearpad of 50 sheets; plus shipping and handling. Item number: 438.

Abstract (AB): This patient education fact sheet helps patients understand ostomy care, notably how to empty and clean a two-piece ostomy pouch. Written in nontechnical language and illustrated with friendly, colorful graphics, the fact sheet first discusses how to know when to empty the pouch and then walks readers through the steps for emptying the pouch. Readers are encouraged to work closely with their health care provider to address any questions or concerns about caring for their ostomy. The reverse side of the fact sheet lists the steps for cleaning the two-piece pouch. With a two-piece system, the patient may choose to snap off the soiled pouch and put a new pouch on the intact wafer. The patient can then empty, clean, and air dry the soiled pouch. The 2 pouches can be alternated like this for 1 to 2 weeks. 5 figures.
Major Descriptors (MJ): Digestive System Diseases. Stoma. Colostomy. Ostomy Supplies. Self Care.
Minor Descriptors (MN): Patient Education. Equipment and Supplies. Defecation.
Verification/Update Date (VE): 200401.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 09910.

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10. Continent Ileostomy (Kock Pouch).
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2001.

Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Fogel, S.L.
Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 191-195.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.
Abstract (AB): This chapter on the continent ileostomy (Kock pouch) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). The Brooke ileostomy should still be considered the gold standard in terms of health, functional abilities, and stability for patients with disease that requires removal or diversion of the entire colon. However, the Brooke ileostomy is still viewed by many as less than ideal, and the majority of people facing proctocolectomy would rather do without the bag and without storage of stool on the outside of the body. The first reasonably successful procedure that was developed to overcome this objection was the continent ileostomy, or Kock pouch. The Kock pouch is based on the concept of a reservoir of bowel with a reverse intussusception to create a valve. The valve projects into the lumen of the pouch and creates continence. As stool fills the pouch and pressure increases, it presses on the outer portion of the valve, squeezing it shut. Defecation is accomplished by passing a tube through the stoma into the pouch, overcoming the resistance of the valve. This allows stool to flow out through the tube, emptying the pouch. The author of this chapter focuses on some of the complications of the Kock pouch and how to address them. Early problems can include ischemia (lack of blood flow) of the pouch or outflow tract, anastomotic leak, transvalvular fistula, stomal stenosis, valve disruption, and pouchitis; later problems can include late pouchitis, valve prolapse, and valve disruption. The author stresses the importance of patient education in terms of self care and monitoring for these complications, so they can be caught early and treated successfully. 9 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Surgical Techniques. Surgery. Continent Ileostomy. Postoperative Complications.

Minor Descriptors (MN): Patient Education. Symptoms. Enterostomal Therapists. Delivery of Health Care. Patient Selection. Quality of Life. Ileal Pouch.
Verification/Update Date (VE): 200201.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08588.
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11. Ileoanal Pouch Anastomosis.

Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Remzi, F.H.; Fazio, V.W.

Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 197-202.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.
Abstract (AB): This chapter on ileoanal pouch anastomosis is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). The authors report that long term follow-up of pouch function and quality of life indicates a very high degree of acceptance and happiness level of the patients undergoing restorative proctocolectomy (RP). In ileoanal pouch anastomosis (IPAA), the entire diseased colon and rectum are removed, but the anal sphincters are preserved. A new rectum is formed from the terminal ileum (ileal pouch); attaching the pouch to the anal canal restores defecation to the standard transanal route with satisfactory fecal continence. Bowel movement frequency ranges from four to nine movements every 24 hours, averaging six times per day. This, however, is not a good indication of success as many patients will evacuate their pouches when it is convenient to do so, rather than defer defecation. Urgency, defined as inability to defer defecation for 15 minutes, is a major concern for many patients preoperatively. Invariably, this is negated by the pouch procedure; the exception is when patients develop pouchitis. Pad use, either due to need or for a sense of security, increases with age, episodes of pouchitis, and the patients with mucosal stripping of the anal canal as well as decreasing sphincter function. Operative mortality (deaths from the surgery) remains under 0.5 percent and reported impotence rates are less than 1 percent. Although dyspareunia (painful sexual intercourse) may occur post-pouch construction, overall, there is an improvement in female sexual function post-pouch compared to pre-pouch. Perhaps the most singled out problem of the pelvic pouch procedure is that of pouchitis; by eliminating one disease, the patient is set up for another. Yet this has to be viewed with the perspective that 90 percent of pouchitis cases are transient and easily treated, and that fewer than three-quarters of patients are subject to repeated episodes. Patients, in their quest for preservation of their anal function, understand and generally are satisfied with the trade-off of RP. 1 figure. 15 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Surgical Techniques. Surgery. Continent Ileostomy. Postoperative Complications.
Minor Descriptors (MN): Patient Education. Symptoms. Enterostomal Therapists. Delivery of Health Care. Patient Selection. Quality of Life. Ileal Pouch. Activities of Daily Living. Defecation. Infections. Prevention.
Verification/Update Date (VE): 200201.

Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08589.
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12. Long-Term Results with Ileoanal Pouch.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Pemberton, J.H.
Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 203-207.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.

Abstract (AB): This chapter on long term results with an ileoanal pouch is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and UC, together known as inflammatory bowel disease (IBD). In ileoanal pouch anastomosis (IPAA), the entire diseases colon and rectum are removed, but the anal sphincters are preserved. A new rectum is formed from the terminal ileum (ileal pouch); attaching the pouch to the anal canal restores defecation to the standard transanal route with satisfactory fecal continence. IPAA is a complex, sophisticated operation, and complications occur frequently. The overall rate of morbidity (complications or illness associated with the procedure) for all patients still hovers between 25 and 30 percent. Failure, however, is rare, even in those who suffer a postoperative complication. The author describes the experience at the Mayo Clinic, where 94 percent of patients have a successful outcome. The author stresses that it is just as important to understand the complications of restorative proctocolectomy, how to avoid them, and what to do if they occur as it is to know how to select appropriate patients and how to perform the procedure rapidly and accurately. Although it is not discussed any further here, the key to a successful outcome is a surgeon who performs the operation effortlessly; the operation struggled through is the one fraught with complications and sometimes failure. Follow up to screen for cancer and the presence of dysplasia (dysfunctional cells) is crucial. Other special situations include pregnancy and psychological factors that may contribute to pouch dysfunction or complications. 9 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Surgery. Continent Ileostomy. Postoperative Complications. Follow Up of Treatment.
Minor Descriptors (MN): Patient Education. Symptoms. Enterostomal Therapists. Delivery of Health Care. Patient Selection. Quality of Life. Ileal Pouch. Activities of Daily Living. Defecation. Infections. Prevention. Surgical Techniques.
Verification/Update Date (VE): 200201.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08590.

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13. Ileoanal Pouch: Evaluation of Excessive Bowel Movements.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09). REVIEW (46).
Language(s) (LG): English.
Year Published (YR): 2001.

Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Egan, L.J.; Phillips, S.F.
Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 209-213.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.
Abstract (AB): This chapter on coping with one complication of the ileoanal pouch (excessive bowel movements) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). In ileoanal pouch anastomosis (IPAA), the entire diseases colon and rectum are removed, but the anal sphincters are preserved. A new rectum is formed from the terminal ileum (ileal pouch); attaching the pouch to the anal canal restores defecation to the standard transanal route with satisfactory fecal continence. However, after IPAA, patients always defecate more frequently than do healthy people. Thus, after procto-colectomy, whether surgical continuity is restored with a terminal ileostomy or with a pouch, daily fecal volumes will be 500 to 700 milliliters (in health, fecal volumes do not often exceed 200 milliliters). Moreover, the reservoir of an ileoanal pouch is smaller than that of a normalrectum. Patients who complain of frequent bowel movements after IPAA must recognize their symptoms in this context; they will never have only one or two solid stools daily. Although patients who complain of frequent defecation after IPAA may have no identifiable pathology, they can, nevertheless, be helped to accept a new lifestyle by being taught to understand the postoperative physiology. Moreover, simple antidiarrheal therapy may significantly improve their lifestyle. A minority of patients with pouch problems (due to pouchitis, Crohn’s disease of the pouch, or cuffitis) do not response to immunosuppressive medications; the resulting chronic inflammation leads to a scarred, noncompliant pouch. In such patients, it may become futile to continue attempts at medical therapy, because their quality of life will be much better after pouch excision and permanent ileostomy. 2 tables. 9 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Surgery. Continent Ileostomy. Postoperative Complications. Follow Up of Treatment. Defecation.

Minor Descriptors (MN): Patient Education. Symptoms. Enterostomal Therapists. Delivery of Health Care. Patient Selection. Quality of Life. Ileal Pouch. Activities of Daily Living. Diarrhea. Drug Therapy. Infections. Prevention. Surgical Techniques.
Verification/Update Date (VE): 200201.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08591.
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14. Ileoanal Pouch Surgery in Childhood.

Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Fonkalsrud, E.W.

Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 215-218.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.
Abstract (AB): This chapter on ileoanal pouch surgery in childhood is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). In ileoanal pouch anastomosis (IPAA), the entire diseased colon and rectum are removed, but the anal sphincters are preserved. A new rectum is formed from the terminal ileum (ileal pouch); attaching the pouch to the anal canal restores defecation to the standard transanal route with satisfactory fecal continence. Ulcerative colitis is more severe in children than in adults and often has more acute symptoms. A child’s growth may be markedly delayed by the UC as well as by long-term steroids and immunosuppressive medications. If colectomy is not performed until late adolescence, the child may never experience ‘catch-up’ growth. Total colectomy with IPAA is a safe operation with approxi-mately 95 percent of children functioning well more than 5 years after operation. The majority of postsurgical complications that might be encountered are correctable. The author cautions that children with the onset of UC under the age of 16 years are at much higher risk for developing carcinoma of the colon or rectum than are older patients, and those with the stapled anastomosis will require a lifetime of annual surveillance sigmoidoscopy. 1 figure. 1 table. 5 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Surgery. Continent Ileostomy. Postoperative Complications. Children. Adolescents. Surgical Techniques.
Minor Descriptors (MN): Patient Education. Symptoms. Patient Selection. Quality of Life. Ileal Pouch. Activities of Daily Living. Diarrhea. Drug Therapy. Infections. Prevention. Child Development. Growth.
Verification/Update Date (VE): 200201.

Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08592.
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15. Chronic Pouchitis.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Schwartz, D.A.; Sandborn, W.J.
Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 219-223.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.

Abstract (AB): This chapter on coping with one complication of the ileoanal pouch (chronic pouchitis) is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). In ileoanal pouch anastomosis (IPAA), the entire diseases colon and rectum are removed, but the anal sphincters are preserved. A new rectum is formed from the terminal ileum (ileal pouch); attaching the pouch to the anal canal restores defecation to the standard transanal route with satisfactory fecal continence. The most frequent long term complication of IPAA is nonspecific inflammation of the ileal pouch, commonly referred to as pouchitis. Of the patients with chronic pouchitis (approximately 5 percent of all patients with IPAA), almost half will require surgical excision or exclusion of the pouch for medically refractory (resistant to treatment) disease. The authors review the treatment options and the algorithm they use to treat chronic pouchitis. The authors stress that it is important to separate patients with chronic pouchitis into groups of those with treatment-responsive pouchitis and those with treatment-resistant pouchitis. In general, the vast majority of patients fall into the treatment responsive category and do very well on intermittent antibiotic therapy. Those who have frequent relapses (i.e., more than 2 in a short period of time) are classified as having chronic pouchitis and are put on maintenance antibiotics. If resistance to one antibiotic develops, rotating multiple antibiotics seems to lessen this problem. 1 figure. 1 table. 10 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Continent Ileostomy. Postoperative Complications. Infections. Chronic Disease.
Minor Descriptors (MN): Patient Education. Symptoms. Patient Selection. Quality of Life. Ileal Pouch. Activities of Daily Living. Drug Effects. Antibiotics. Surgery.
Verification/Update Date (VE): 200201.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08593.

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16. Endoscopy in Evaluating Ileal Pouches.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2001.

Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Chutkan, R.K.; Waye, J.D.
Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 225-227.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.
Abstract (AB): This chapter on the use of endoscopy in evaluating ileal pouches is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and ulcerative colitis (UC), together known as inflammatory bowel disease (IBD). The authors describe the use of endoscopy to evaluate the continent ileostomy (Kock pouch) which is based on the concept of a reservoir of bowel with a reverse intussusception to create a valve. The valve projects into the lumen of the pouch and creates continence. As stool fills the pouch and pressure increases, it presses on the outer portion of the valve, squeezing it shut. Defecation is accomplished by passing a tube through the stoma into the pouch, overcoming the resistance of the valve. This allows stool to flow out through the tube, emptying the pouch. The authors also describe the use of endoscopy to evaluate the ileoanal pouch anastomosis (IPAA), in which the entire diseased colon and rectum are removed, but the anal sphincters are preserved. A new rectum is formed from the terminal ileum (ileal pouch); attaching the pouch to the anal canal restores defecation to the standard transanal route with satisfactory fecal continence. Problems with the IPAA that may be evaluated with endoscopy include surveillance for dysplasia (growth of dysfunctional tissue), pelvic sepsis, small bowel obstruction, pouchitis, stricture formation, and fecal incontinence and fistula (abnormal passageway). 3 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Surgical Techniques. Continent Ileostomy. Postoperative Complications. Diagnosis. Endoscopy.

Minor Descriptors (MN): Equipment and Supplies. Diagnostic Tests. Patient Education. Symptoms. Enterostomal Therapists. Delivery of Health Care. Ileal Pouch. Obstruction. Fecal Incontinence.
Verification/Update Date (VE): 200201.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08594.
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17. Role for the Pathologist in Evaluating Chronic Pouches.

Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Petras, R.E.

Source (SO): In: Bayless, T.M. and Hanauer, S.B. Advanced Therapy of Inflammatory Bowel Disease. Hamilton, Ontario: B.C. Decker Inc. 2001. p. 229-232.
Availability (AV): Available from B.C. Decker Inc. 20 Hughson Street South, P.O. Box 620, L.C.D. 1 Hamilton, Ontario L8N 3K7. (905) 522-7017 or (800) 568-7281. Fax (905) 522-7839. Email: info@bcdecker.com. Website: www.bcdecker.com. PRICE: $129.00 plus shipping and handling. ISBN: 1550091220.
Abstract (AB): Evolving surgical techniques have changed the pathologist’s role in the analysis of inflammatory bowel disease (IBD). Patients with ulcerative colitis (UC) have several surgical options that either create continence in an ileostomy (Kock pouch) or preserve anal sphincter function and restore continuity to the bowel (ileal pouch-anal anastomosis or IPAA). This chapter on the role of the pathologist in evaluating chronic pouches is from the second edition of a book devoted to the details of medical, surgical, and supportive management of patients with Crohn’s disease (CD) and UC, together known as inflammatory bowel disease (IBD). The two operations have in common the creation of a reservoir or pouch, formed by interconnecting loops of terminal ileum. In general, these pouch procedures are contraindicated in patients with Crohn’s disease (CD) because of increased morbidity including fistula and abscess. Pouch complications include inflammation, fistula, obstruction, incontinence, and anastomotic leaks. Although many complications result from surgical and mechanical difficulties, and others relate to the development of ‘primary’ inflammation in the pouch (pouchitis), some of these complicated cases likely represent pouch recurrence of initially undiagnosed CD. These cases illustrate the inability to reliably differentiate UC from CD especially in severe colitis, even after examination of the colectomy specimen. Virtually all reports of surgical experience with IPAA for presumed UC contain approximately 2 to 7 percent of patients in whom the actual diagnosis proved to be CD. These cases usually present as late pouch abscesses or fistulae. Patients with these complications should be investigated with pouch biopsy to look for evidence of CD and also should prompt review of the original colectomy specimen, considering it from the viewpoint of the classification system outlined in this chapter. 2 tables. 18 references.
Major Descriptors (MJ): Digestive System Diseases. Inflammatory Bowel Disease. Ulcerative Colitis. Patient Care Management. Enterostomal Therapy. Surgical Techniques. Continent Ileostomy. Ileal Pouch. Patient Care Team. Postoperative Complications. Diagnosis.
Minor Descriptors (MN): Crohns Disease. Diagnostic Tests. Pathology. Symptoms. Enterostomal Therapists. Delivery of Health Care. Diarrhea. Fecal Incontinence. Stoma. Abscess. Fistula. Obstruction.
Verification/Update Date (VE): 200201.

Notes (NT): CP: Yes.
Accession Number (AN): DD BK 08595.
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18. New Surgical Options for the Treatment of Ulcerative Colitis: Questions and Answers.
Subfile: Digestive Diseases
Format (FM): BROCHURE (08).

Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): PATIENT (400).
Corporate Author (CN): American Society of Colon and Rectal Surgeons (ASCRS).
Source (SO): Arlington Heights, IL: American Society of Colon and Rectal Surgeons. 1996. [2 p.].
Availability (AV): Available from American Society of Colon and Rectal Surgeons. 85 West Algonquin Road, Suite 550, Arlington Heights, IL 60005. (800) 791-0001 or (847) 290-9184. Fax (847) 290-9203. E-mail: ascrs@fascrs.org. Website: www.fascrs.org. PRICE: Full-text available online at no charge; Single copy free; bulk copies available.

Abstract (AB): This patient education brochure describes new surgical treatments for ulcerative colitis (UC), an inflammation of the lining of the large bowel (colon). Symptoms of UC include rectal bleeding, diarrhea, abdominal cramps, weight loss, and fever. In addition, patients who have had extensive UC for many years are at an increased risk to develop large bowel cancer. Initial treatment of UC is medical, using antibiotics and antiinflammatory medications. Surgery is indicated for patients who have life threatening complications of inflammatory bowel diseases, such as massive bleeding, perforation, or infection. It may also be necessary for those who have the chronic form of the disease, which fails medical therapy. Historically, the standard operation for UC has been removal of the entire colon, rectum, and anus; this procedure is called a proctocolectomy. This operation requires creation of a Brooke ileostomy and chronic use of an appliance on the abdominal wall to collect waste from the bowel. Another option is the continent ileostomy, in which an internal reservoir is created. The bowel still comes through the abdominal wall, but an external appliance is not required. This option eliminates the risks of cancer and risks of recurrent persistent colitis, but the internal reservoir may begin to leak and require another surgical procedure to revise the reservoir. Some patients may be treated by removal of the colon, with preservation of the rectum and anus. The small bowel can then be reconnected to the rectum and the person retains continence. This avoids the ileostomy, but the risks of ongoing active colitis, increased stool frequency, urgency, and cancer in the retained rectum remain. The brochure then describes the ileoanal procedure, a newer alternative for the management of UC in which all of the colon and rectum are removed, but the anal canal is preserved. The rectum is replaced with a small bowel, which is fashioned to form a small pouch. The pouch acts as a reservoir to help decrease the stool frequency. This maintains a normal route of defecation, but most patients experience 5 to 10 bowel movements per day. The brochure concludes by encouraging readers to educate themselves about these alternatives, so that they can take part in the decisions about their own health care and pursue the highest quality of life. 8 figures.
Major Descriptors (MJ): Digestive System Diseases. Ulcerative Colitis. Surgical Techniques. Ileostomy. Therapy.
Minor Descriptors (MN): Patient Education. Risk Factors. Postoperative Complications. Surgery. Symptoms. Defecation. Continent Ileostomy. Ileal Pouch. Rectum. Anus. Intestines.
Verification/Update Date (VE): 200308.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 07275.

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19. Colostomy Guide.
Subfile: Digestive Diseases
Format (FM): BROCHURE (08). POLICY/GUIDELINES (50). TEACHING GUIDE (55).
Language(s) (LG): English.
Year Published (YR): 2001.

Audience code (AC): PATIENT (400).
Corporate Author (CN): United Ostomy Association, Inc.
Source (SO): Irvine, CA: United Ostomy Association. 2001. 27 p.
Availability (AV): Available from United Ostomy Association, Inc. 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612-2405. (800) 826-0826. Fax: (949) 660-8624. E-mail: info@uoa.org. Website: www.uoa.org. PRICE: $3.50.
Abstract (AB): An colostomy is a surgically created opening in the large intestine (colon), through the abdominal wall, for discharge of bowel contents following disease or injury. This booklet offers colostomy patients suggestions and ideas for managing their colostomy. Topics covered include basic facts about colostomies, different types of colostomies, methods of colostomy care, diet, odor, gas and noise, constipation, diarrhea, equipment and supplies, colostomy complications, and activities of daily life with a colostomy. A brief review of the activities, goals, and contact information of the United Ostomy Association (www.uoa.org); the Wound, Ostomy and Continence Nurses Society(www.wocn.org); and the American Cancer Society (www.cancer.org) is provided. The booklet concludes with a glossary of terms. Simple line drawings illustrate the booklet. 12 figures.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Postoperative Care. Surgery. Patient Care Management. Activities of Daily Living.

Minor Descriptors (MN): Surgical Techniques. Patient Education. Stoma. Postoperative Complications. Defecation. Diet. Recreation. Information Resources. Diarrhea. Constipation. Travel. Sexuality. Workplace.
Verification/Update Date (VE): 200310.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 09661.
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20. Ileostomy Guide.

Subfile: Digestive Diseases
Format (FM): BROCHURE (08). POLICY/GUIDELINES (50). TEACHING GUIDE (55).
Language(s) (LG): English.
Year Published (YR): 2001.
Audience code (AC): PATIENT (400).
Corporate Author (CN): United Ostomy Association, Inc.

Source (SO): Irvine, CA: United Ostomy Association. 2001. 29 p.
Availability (AV): Available from United Ostomy Association, Inc. 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612-2405. (800) 826-0826. Fax: (949) 660-8624. E-mail: info@uoa.org. Website: www.uoa.org. PRICE: $3.50.
Abstract (AB): An ileostomy is a surgically created opening in the abdominal wall, through which the end of the ileum (the lowest portion of the small intestine) is brought to the abdominal wall to form a stoma, for discharge of bowel contents following disease or injury. This booklet offers ileostomy patients suggestions and ideas for managing their ileostomy. Topics covered include basic facts about ileostomies, different types of ileostomies, methods of ileostomy care, diet, odor, gas and noise, diarrhea, equipment and supplies, complications, activities of daily life with an ileostomy, and insurance coverage. A brief review of the activities, goals, and contact information of the United Ostomy Association (www.uoa.org); the Wound, Ostomy and Continence Nurses Society(www.wocn.org); and the American Cancer Society (www.cancer.org) is provided. The booklet concludes with a glossary of terms. Simple line drawings illustrate the booklet. 9 figures.
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Postoperative Care. Surgery. Patient Care Management. Activities of Daily Living.
Minor Descriptors (MN): Surgical Techniques. Patient Education. Stoma. Postoperative Complications. Defecation. Diet. Recreation. Information Resources. Diarrhea. Health Insurance. Travel. Sexuality. Workplace.
Verification/Update Date (VE): 200310.

Notes (NT): CP: Yes.
Accession Number (AN): DD BR 09662.
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21. Ostomy.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.
Year Published (YR): 2000.
Audience code (AC): HEALTH PROFESSIONALS (100).
Corporate Author (CN): Chicago Dietetic Association. South Suburban Dietetic Association. American Dietetic Association.
Source (SO): In: American Dietetic Association. Manual of Clinical Dietetics, Sixth Edition. Chicago, IL: American Dietetic Association. 2000. p.421-424.
Availability (AV): Available from American Dietetic Association. 216 West Jackson Boulevard, Chicago, IL 60606. (800) 877-1600 or (312) 899-0040. Fax (312) 899-4899. PRICE: $59.95 for members, $70.00 for nonmembers. ISBN: 0880911875.

Abstract (AB): Medical nutrition therapy (MNT) is used for patients who have had a surgical ileostomy or colostomy to minimize the risk of obstruction, to prevent fluid and electrolyte imbalances, to reduce excessive output, and to minimize gas and unpleasant odors. This chapter on nutrition care for patients with an ostomy is from a comprehensive manual of clinical dietetics designed to help dietitians, physicians, and nurses deliver quality nutrition care. The chapter includes the purpose of nutrition care, the indications for use, a description of the diet, meal planning approaches, a definition of the disease or condition, and a discussion section. Conditions most commonly associated with ostomy placement include Crohn’s disease, diverticulitis, ulcerative colitis, colorectal cancer, familial polyposis, intestinal trauma, bowel ischemia, and radiation enteritis. One chart summarizes food selection guidelines for people with ostomies. 1 table. 4 references.
Major Descriptors (MJ): Digestive System Diseases. Nutrition. Diet Therapy. Guidelines. Patient Care Management. Medical Nutrition Therapy. Ostomy. Colostomy. Ileostomy.
Minor Descriptors (MN): Patient Education. Patient Selection. Postoperative Complications. Quality of Care. Delivery of Health Care. Symptoms. Flatulence. Prevention.
Verification/Update Date (VE): 200301.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 09177.

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22. ‘Cuffitis’ and Inflammatory Changes in the Columnar Cuff, Anal Transitional Zone, and Ileal Reservoir After Stapled Pouch-Anal Anastomosis.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1999.

Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Thompson-Fawcett, M.W.; Mortensen, N.J.M.; Warren, B.F.
Source (SO): Diseases of the Colon and Rectum. 42(3): 348-355. March 1999.
Availability (AV): Available from Williams and Wilkins. 352 West Camden Street, Baltimore, MD 21201-2436.
Abstract (AB): During the past 8 to 10 years, most surgeons have adopted the double stapled technique to accomplish the pouch anal anastomosis in restorative proctocolectomy for ulcerative colitis. Little attention has been focused on the functional implications of retaining a segment of diseased columnar mucosa in the upper anal canal. This article reports on a study undertaken to investigate clinically significant inflammation in the columnar cuff. In all, 113 patients were studied, and 715 biopsies were performed over a 2.5 year period. Biopsy specimens were taken from two or three sites, including the columnar cuff, ileal pouch, and anal transitional zone. Acute and chronic inflammation was scored for biopsy specimens from all three sites and compared with endoscopic assessment and pouch function. In the columnar cuff, acute histologic inflammation was found in 13 percent of patients, and in 9 percent it was symptomatic during followup and was accompanied by evidence of endoscopic inflammation. Most patients had mild inflammation in the cuff that persisted over time. Inflammation in the pouch, pouch frequency, and anastomotic height were not related to columnar cuff inflammation. They conclude that cuffitis is a cause of pouch dysfunction after a double stapled restorative proctocolectomy. The authors propose a triad of diagnostic criteria, including symptoms and endoscopic and histologic inflammation, to identify and subsequently treat this problem. 1 figure. 4 tables. 15 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Ileoanal Reservoir. Continent Ileostomy. Ileal Pouch. Postoperative Complications. Infection.

Minor Descriptors (MN): Delivery of Health Care. Patient Selection. Surgical Techniques. Symptoms. Risk Factors. Inflammatory Bowel Disease.
Verification/Update Date (VE): 199907.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 06967.
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23. Unexpected Journey.

Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): PATIENT (400).
Author (AU): Schnippert, A.

Source (SO): Ostomy Quarterly. 36(3): 52-56. Spring 1999.
Availability (AV): Available from Ostomy Quarterly. 36 Executive Park, Suite 120, Irvine, CA 92614-6744. (800) 826-0826 or (714) 660-8624.
Abstract (AB): In this article, from a magazine for people who have an ostomy, the author retells her story of surviving emergency colectomy surgery and adjusting to having an ileostomy. She shares her experiences as she was diagnosed with and treated for ulcerative proctitis, and went through a couple of flareups of the disease, the final one culminating in emergency surgery to remove her colon. Her colon had perforated in three areas, at the bottom, in the middle, and at the top, and was ready to go in numerous other places. The contamination from the perforation put her at risk for total organ shutdown, and she was treated in intensive care for 3 days. She describes the recovery process as the hardest part, as it entailed 6 weeks in the hospital and a long rehabilitation time at home. She also addresses the psychological adjustment to having an ileostomy, focusing on concerns about self image and sexuality. She concludes by discussing her activities with her family, her travel, and her volunteer work as a patient representative for others going through ostomy surgery. 3 figures.
Major Descriptors (MJ): Digestive System Diseases. Ostomy. Ileostomy. Case Reports. Psychosocial Factors.
Minor Descriptors (MN): Surgery. Coping. Adjustment. Rehabilitation. Postoperative Care. Patient Advocacy. Activities of Daily Living.
Verification/Update Date (VE): 199910.

Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07199.
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24. Ileoanal Procedures: Acute and Long-Term Management Issues.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Hull, T.L.
Source (SO): Journal of WOCN. Journal of Wound, Ostomy and Continence Nurses. 26(4): 201-206. July 1999.
Availability (AV): Available from Journal of WOCN, Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 453-4351.

Abstract (AB): Patients with ulcerative colitis (UC) and familial adenomatous polyposis traditionally underwent a total proctocolectomy and permanent ileostomy when surgery was required. However, in the late 1970s the pelvic pouch procedure was introduced and has since become the preferred surgical treatment for these patients. This article reviews the acute and long term management issues of working with patients with ileoanal procedures. The author notes that even though this operation avoids a permanent stoma and usually improves the quality of life of these patients, it does not restore ‘normal’ bowel function as compared with persons with an intact gastrointestinal system. Rather, patients can expect to have at least 6 stools per day, and the consistency of the stool is expected to vary from pasty to watery. As with any bowel operation, patients experience many changes in gastrointestinal function that affect both the immediate postoperative period and beyond. Acute management issues include infection and stoma care; chronic management issues include skin care, diarrhea, nocturnal defecation, pouchitis, bowel obstruction and emptying problems, risk of cancer, and sexuality concerns. The author stresses the importance of counseling patient before pelvic pouch construction so they are aware of these potential management issues and understand the importance of lifelong followup and monitoring of their pelvic pouch. 1 table. 20 references.
Major Descriptors (MJ): Digestive System Diseases. Ileal Pouch. Postoperative Care. Postoperative Complications. Patient Care Management. Continent Ileostomy.
Minor Descriptors (MN): Risk Factors. Infection. Ulcerative Colitis. Familial Polyposis. Defecation. Skin Care. Stoma. Sexuality. Intestinal Obstruction.
Verification/Update Date (VE): 200001.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07303.

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25. Lived Experience of Having an Ileoanal Reservoir: A Phenomenologic Study.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1999.

Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Beitz, J.M.
Series (SE): (Ostomy Care).
Source (SO): Journal of WOCN. Journal of Wound, Ostomy and Continence Nurses. 26(4): 185-200. July 1999.
Availability (AV): Available from Journal of WOCN, Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 453-4351.
Abstract (AB): Ileoanal reservoir (IAR) surgery or ileal pouch anastomosis is a relatively new surgical technique for people with ulcerative colitis (UC) or familial adenomatous polyposis. Little attention has been given to the experiences of the people who undergo the procedure. This article reports on a qualitative study to understand the lived experience of persons who have had construction of an IAR. The study was grounded in the phenomenologic approach of Van Manen to capture the lived experience of having an IAR as perceived by those persons in their everyday world. A purposive sample of 10 individuals with direct and personal knowledge of the experience were interviewed in detail. Subjects were recruited by contact with an IAR support group and a local WOCN group. Data collection involved face to face interviews lasting from 1 to 2 hours; interviews were audiotaped and transcribed. Demographic data from the interviews were tabulated. Analyses of transcripts revealed 10 essential thematic categories with multiple theme clusters of the IAR experience, related to lived body, time, space, and relationships. The thematic categories are restricted life world, living with uncertainty and fear, seeking control, vicious cycles of crisis and normalcy, seeking and giving support, alienation from the body, living with bodily alterations, the gift of time, role and relationship changes, and the ‘end of the tunnel.’ The study provides a portrait of courage and survival for individuals experiencing major surgical interventions and bodily invasion associated with IAR after years of living with UC. The author discusses the implications for nurses and health care personnel. 3 tables. 44 references.

Major Descriptors (MJ): Digestive System Diseases. Ileal Pouch. Postoperative Care. Postoperative Complications. Patient Care Management. Continent Ileostomy. Quality of Life.
Minor Descriptors (MN): Risk Factors. Ulcerative Colitis. Familial Polyposis. Sexuality. Interpersonal Relations. Caregivers. Psychosocial Factors. Chronic Disease. Activities of Daily Living.
Verification/Update Date (VE): 200001.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 07304.
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26. Emptying Your Pouch.
Subfile: Digestive Diseases
Format (FM): FACT SHEET (22).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): PATIENT (400).

Corporate Author (CN): Krames Communications.
Series (SE): (Ostomy Care Tearsheet Series).
Source (SO): San Bruno, CA: Krames Communications. 1999. 2 p.
Availability (AV): Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066. (800) 333-3032. Fax (415) 244-4512. PRICE: $9.95 for pad of 50 sheets.
Abstract (AB): This patient education fact sheet provides information for people who have a colostomy. The fact sheet describes the recommended technique of emptying a drainable pouch. The fact sheet recommends emptying a drainable pouch when it gets to be about one-third full. This keeps the pouch from bulging under clothes and also helps prevent leaking and odor. The front side of the fact sheet describes and illustrates three steps: emptying, cleaning, and reclamping the pouch. The back side of the fact sheet describes the method recommended for releasing gas that collects in the pouch. The back side of the fact sheet also provides blank space for individualized patient instructions. The fact sheet is illustrated with full-color line drawings that depict each step described.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Patient Education. Self Care. Ostomy Supplies.

Minor Descriptors (MN): Stoma. Activities of Daily Living. Guidelines. Defecation.
Verification/Update Date (VE): 200008.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 05752.
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27. Living With Your Colostomy: A Guide to Self-Care.

Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Krames Communications.

Source (SO): San Bruno, CA: StayWell Company. 1999. 24 p.
Availability (AV): Available from StayWell Company. 1100 Grundy Lane, San Bruno, CA 94066-3030. (800) 333-3032. Fax (650) 244-4512. Website: www.staywell.com. PRICE: $1.75 each; discounts available for larger quantities.
Abstract (AB): This patient education booklet provides information for people who have just received a colostomy and for people who are about to undergo colostomy surgery. After an introductory section that emphasizes the important role the patient plays on the health care team, the booklet covers: the anatomy of the digestive tract, how a colostomy works, pouch selection, stoma care, emptying and changing the pouch, irrigating a colostomy to time the bowel movements, avoiding digestive problems, what to do if a food blockage occurs, and psychosocial adjustment to the physical changes accompanying a colostomy. Step-by-step details of the care and maintenance of a stoma and the required supplies are provided. The booklet concludes with a list of common questions and answers, a glossary of terms, and a list of resource organizations. The booklet is illustrated with full-color line drawings that support the concepts and that depict a range of ethnic groups and ages.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Patient Education. Self Care.
Minor Descriptors (MN): Ostomy Supplies. Stoma. Physiology. Psychosocial Factors. Activities of Daily Living. Nutrition. Food. Guidelines.
Verification/Update Date (VE): 200011.

Notes (NT): CP: Yes.
Accession Number (AN): DD BR 05751.
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28. Care for the Child with an Ostomy: A Guide for Parents.
Subfile: Digestive Diseases
Format (FM): VIDEORECORDING, VIDEOCASSETTE TAPES (84).

Language(s) (LG): English.
Year Published (YR): 1999.
Audience code (AC): PATIENT (400).
Corporate Author (CN): United Ostomy Association, Inc.
Source (SO): Irvine, CA: United Ostomy Association, Inc. 1999. (videocassette).
Physical description (PD): VHS videocassette (13 min, 47 sec), col.

Availability (AV): Available from United Ostomy Association, Inc. 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612-2405. (800) 826-0826. Fax: (949) 660-8624. E-mail: info@uoa.org. Website: www.uoa.org. PRICE: $12.00.
Abstract (AB): An ostomy is a surgically created opening in the abdominal wall through which stool or urine passes. The opening on the skin is called a stoma. A dressing or collection pouch is worn over the stoma to collect the waste. This videotape program offers an introduction for parents in the management care for an infant or child who has a colostomy. The video includes demonstration of one method of pouching an infant’s colostomy stoma as well as information about professional and community resources for parents or others who will care for the child with any type of ostomy. The video encourages parents to work closely with the enterostomal therapy (ET) nurse, a registered nurse with additional training and experience in the teaching about the care of all types of ostomies and related surgeries. The accompanying brochure notes the toll free number of the United Ostomy Association (800-660-8624), through which parents can locate support groups in their own area.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Self Care. Parent Education. Equipment and Supplies. Infants. Children.
Minor Descriptors (MN): Ostomy Supplies. Postoperative Care. Complications. Skin Care. Caregivers. Instructional Materials. Audiovisual Materials. Nursing Care. Support Groups.
Verification/Update Date (VE): 200310.
Notes (NT): CP: Yes.

Accession Number (AN): DD AV 09707.
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29. Hirschsprung’s Disease: A Guide for Parents-Caretakers.
Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.

Year Published (YR): 1998.
Audience code (AC): PATIENT (400). COMMUNITY SERVICE PROFESSIONALS (200).
Corporate Author (CN): American Pseudo-Obstruction and Hirschsprung’s Disease Society, Inc.
Source (SO): North Andover, MA: American Pseudo-Obstruction and Hirschsprung’s Disease Society, Inc. 1998. 8 p.
Availability (AV): Available from American Pseudo-Obstruction and Hirschsprung’s Disease Society, Inc. 158 Pleasant Street, North Andover, MA 01845. (978) 685-4477. Fax (978) 685-4488. E-mail: aphs@tiac.net. PRICE: Single copy free.
Abstract (AB): Hirschprung’s disease (congenital intestinal aganglionosis) is a lack of nerve cell bodies in a segment of the bowel. This interferes with the coordinated squeezing action called peristalsis which normally moves intestinal contents forward. This brochure provides information for parents and other caregivers of children with Hirschsprung’s disease. Written in question and answer format, the brochure covers diagnosis, incidence, causes, surgical treatment of children with Hirschsprung’s disease, medical followup, postoperative care and complications, and the genetic implications (for future family planning). In the majority of children with Hirschsprung’s, the disease is limited to the rectum or the rectosigmoid colon, often termed short segment disease. In young, small, and sick infants, a temporary colostomy or ileostomy may be performed. Later, when the child reaches the weight, age, or condition desired by the surgeon, surgery will close the colostomy or ileostomy in one or two stages. The brochure describes the three common reconstructive operations: the Swenson, the Soave, and the Duhamel. The brochure concludes with a lengthy glossary and is illustrated with simple anatomical drawings of the different types of colostomies, including ileostomy, ascending colostomy, transverse colostomy, descending colostomy, and sigmoid colostomy. The brochure includes a brief description of the American Pseudo-obstruction and Hirschsprung’s Disease Society (APHS), an organization that offers support and information through parent networking, newsletters, meetings, educational symposia, other publications, and a Hirschsprung’s registry. 6 figures.

Major Descriptors (MJ): Digestive System Diseases. Hirschsprung Disease. Children. Diagnosis. Surgery. Colostomy.
Minor Descriptors (MN): Diagnostic Tests. Symptoms. Surgical Techniques. Infants. Parent Education. Support Groups. Postoperative Complications. Physiology. Motility Disorders.
Verification/Update Date (VE): 199811.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 06545.
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30. Complications of Ostomy Construction.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1998.
Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Fleshman, J.W.
Series (SE): (Ostomy Surgery).
Source (SO): Ostomy Quarterly. 35(2): 51, 53. Winter 1998.
Availability (AV): Available from Ostomy Quarterly. 36 Executive Park, Suite 120, Irvine, CA 92614-6744. (800) 826-0826 or (714) 660-8624.
Abstract (AB): This brief article covers techniques that can reduce the complications associated with ostomy construction surgery. The majority of ostomy complications are a result of technical problems during surgery, and are caused by improper positioning of the stoma or inadequate blood supply. A smaller set of complications is due to the body habitus and the tissue healing process after surgery. The majority of complications such as hernia, difficulty maintaining an appliance, or skin problems, can be avoided by marking a proper stoma site before surgery. The author describes his practice of marking the ostomy site before surgery, in consultation with an enterostomal therapy (ET) nurse, with the patient in all positions (including standing, sitting, and lying) and wearing their usual clothes (including belts). In this way, the stoma is placed in a position which avoids creases, bony prominences, scars, and constricting clothes or belt lines. The author also discusses complications after ileostomy: the most common complication of an ileostomy is food bolus obstruction either early or late after construction of the ostomy. Dietary indiscretion, by eating food known to cause blockage or overeating alone, may be the cause of this. Adhesions and narrowing of the abdominal wall outlet are also possible sources of partial food bolus obstruction. The author reiterates that the majority of post-ostomy complications are related to surgical technique and can be alleviated by use of preoperative stoma markings.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Ileostomy. Surgical Techniques. Postoperative Complications. Prevention. Preoperative Care.

Minor Descriptors (MN): Delivery of Health Care. Ileostomy. Surgery. Dehydration. Hernia. Pain. Professional Education.
Verification/Update Date (VE): 199807.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 06516.
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31. Guide to Living with an Ileostomy.

Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.
Year Published (YR): 1998.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Canadian Association for Enterostomal Therapy (CAET).

Source (SO): Ottawa, ON: Canadian Association for Enterostomal Therapy. 1998. 28 p.
Availability (AV): Available from Canadian Association for Enterostomal Therapy (CAET). C/O Canadian Nurses Association, 50 The Driveway, Ottawa, ON K2P 1E2. Website: www.caet.ca. PRICE: Contact publisher for price.
Abstract (AB): An ileostomy is a surgically created opening into the last part of the small intestine, which is also called the ileum. This booklet provides information for patients adjusting to living with a ileostomy. The booklet begins with a description of the anatomy and function of the digestive tract and the colon in particular. The booklet then discusses the different types of ileostomies; the stoma and different types of ileostomy stomas (end ileostomy, end ileostomy with a mucus fistula or rectal stump, loop ileostomy); the pouching systems that are used to contain stool, odor, and gas, and to protect the skin; preoperative preparation; postoperative expectations; gaining independence postoperatively; discharge from the hospital; resuming one’s lifestyle (including sexual relations, work, activities, bathing, clothing, and travel), medications; skin care; dietary management (handling excessive gas, odor, diarrhea, and constipation); identifying and managing food blockage or obstruction; and postsurgical visits to the health care provider, including symptoms that should be reported to the enterostomal nurse or doctor. The booklet concludes with a glossary of related terms, a list of the task force members who participated in the creation of the booklet, and a list of Canadian resources through which readers can obtain additional information. Blank space is available for listing the telephone numbers of the reader’s health care providers. 5 figures.
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Postoperative Care. Adjustment. Activities of Daily Living.
Minor Descriptors (MN): Patient Education. Preoperative Care. Postoperative Complications. Diet. Diarrhea. Constipation. Flatulence. Prevention. Self Care. Psychosocial Factors. Coping. Ostomy Supplies.
Verification/Update Date (VE): 200007.

Notes (NT): CP: Yes.
Accession Number (AN): DD BR 07683.
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32. Bowel and Bladder Management.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).

Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): HEALTH PROFESSIONALS (100). COMMUNITY SERVICE PROFESSIONALS (200).
Author (AU): Blackman, J.A.
Source (SO): In: Blackman, J.A. Medical Aspects of Developmental Disabilities in Children Birth to Three. 3rd ed. Gaithersburg, MD: Aspen Publishers, Inc. 1997. p. 11-23.
Availability (AV): Available from Aspen Publishers, Inc. 7201 McKinney Circle, Frederick, MD 21704. (800) 234-1660 or (800) 638-8437. PRICE: $40.00. ISBN: 0834207591.

Abstract (AB): Many infants and young children with developmental disabilities have complex needs related to their bowel and bladder functions. This chapter is part of a book designed to educate health and social service professionals about the medical challenges presented by children (ages 1 to 3) with developmental disabilities. The chapter discusses the management of constipation, intestinal ostomies, and clean intermittent catheterization. For each topic, the author provides information about cause, incidence, medical management, course, accompanying health problems, and possible alternative treatments or problems. The author points out that bowel and bladder problems can interfere with education or therapy services. Black and white photographs and line drawings illustrate some of the concepts presented. 5 figures. 2 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Constipation. Congenital Disorders. Colostomy. Ileostomy. Children. Infants. Urination. Anus. Therapy. Equipment and Supplies. Gastrointestinal Diseases. Colon. Catheters.
Minor Descriptors (MN): Cathartics. Hirschsprung Disease. Diet. Enterocolitis, Pseudomembranous.
Verification/Update Date (VE): 199805.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 01863.

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33. Living With Your Ileostomy: A Guide to Self-Care.
Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.
Year Published (YR): 1997.

Audience code (AC): PATIENT (400).
Corporate Author (CN): Krames Communications.
Source (SO): San Bruno, CA: Krames Communications. 1997. 24 p.
Availability (AV): Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066. (800) 333-3032. Fax (415) 244-4512. PRICE: $1.75; discounts available for larger quantities.
Abstract (AB): This patient education booklet provides information for people who have just received an ileostomy and for people who are about to undergo ileostomy surgery. After an introductory section that emphasizes the important role the patient plays on the health care team, the booklet covers the anatomy of the digestive tract, how an ileostomy works, pouch selection, stoma care, emptying and changing the pouch, avoiding digestive problems, what to do if a food blockage occurs, and psychosocial adjustment to the physical changes accompanying an ileostomy. Step-by-step details of the care and maintenance of a stoma and the required supplies are provided. The booklet concludes with a list of common questions and answers, a glossary of terms, and a list of resource organizations. The booklet is illustrated with full-color line drawings that support the concepts and that depict a range of ethnic groups and ages.
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Patient Education. Self Care.

Minor Descriptors (MN): Ostomy Supplies. Stoma. Physiology. Psychosocial Factors. Activities of Daily Living. Nutrition. Food. Guidelines.
Verification/Update Date (VE): 199704.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 05750.
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34. Changing Your Pouch.

Subfile: Digestive Diseases
Format (FM): FACT SHEET (22).
Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Krames Communications.

Series (SE): (Ostomy Care Tearsheet Series).
Source (SO): San Bruno, CA: Krames Communications. 1997. 2 p.
Availability (AV): Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066. (800) 333-3032. Fax (415) 244-4512. PRICE: $9.95 for pad of 50 sheets.
Abstract (AB): This patient education fact sheet provides information for people who have a colostomy. The fact sheet describes the recommended technique of changing the pouch. The fact sheet recommends changing a drainable pouch one to two times a week. The fact sheet first lists the supplies needed before starting, including plastic bags, toilet paper, a soft washcloth, a clean towel, extra skin barrier, and a new pouch. The fact sheet then describes and illustrates three steps: removing the used pouch, cleaning around the stoma, and putting on the new pouch. The authors provide a list of circumstances in which patients should contact their health care provider. The back side of the fact sheet also provides blank space for individualized patient instructions. The fact sheet is illustrated with full-color line drawings that depict each step described.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Patient Education. Self Care. Ostomy Supplies.
Minor Descriptors (MN): Stoma. Activities of Daily Living. Guidelines. Equipment and Supplies.

Verification/Update Date (VE): 200008.
Notes (NT): CP: Yes.
Accession Number (AN): DD DC 05753.
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35. Irrigating Your Colostomy.
Subfile: Digestive Diseases

Format (FM): FACT SHEET (22).
Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Krames Communications.
Series (SE): (Ostomy Care Tearsheet Series).

Source (SO): San Bruno, CA: Krames Communications. 1997. 2 p.
Availability (AV): Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066. (800) 333-3032. Fax (415) 244-4512. PRICE: $9.95 for pad of 50 sheets.
Abstract (AB): This patient education fact sheet provides information for people who have a colostomy. The fact sheet describes the recommended technique of irrigating a colostomy. Irrigating a colostomy allows patients to time their bowel movements. Once a day, or once every other day, the patient flushes the colostomy with warm water. Equipment required for irrigation includes an irrigation kit, hook, and water soluble lubricant. The fact sheet describes and illustrates the five steps for irrigation: filling the bag, putting on the sleeve, inserting the cone, removing the cone and clamping the sleeve, and cleaning the cone and the sleeve. The back side of the fact sheet also provides blank space for individualized patient instructions. The fact sheet is illustrated with full-color line drawings that depict each step described.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Patient Education. Self Care. Ostomy Supplies.
Minor Descriptors (MN): Stoma. Activities of Daily Living. Guidelines. Defecation. Equipment and Supplies.
Verification/Update Date (VE): 200008.

Notes (NT): CP: Yes.
Accession Number (AN): DD DC 05754.
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36. If You Have a Food Blockage.
Subfile: Digestive Diseases
Format (FM): FACT SHEET (22).

Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Krames Communications.
Series (SE): (Ostomy Care Tearsheet Series).
Source (SO): San Bruno, CA: Krames Communications. 1997. 2 p.

Availability (AV): Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066. (800) 333-3032. Fax (415) 244-4512. PRICE: $9.95 for pad of 50 sheets.
Abstract (AB): This patient education fact sheet provides information for people who have a colostomy. The fact sheet describes what to do if food blockage problems are encountered. The author notes that, after an ostomy, it may be harder to digest food that are high in fiber. Eaten in large amounts, these foods can clump together, causing a blockage. The fact sheet describes the signs of an intestinal blockage, what to do while experiencing these symptoms, and ways to help prevent a blockage. Prevention methods include drinking adequate amounts of fluid, chewing foods thoroughly, and monitoring high fiber intake. The back side of the fact sheet also provides blank space for individualized patient instructions. The fact sheet is illustrated with full-color line drawings that depict each step described.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Patient Education. Intestinal Obstruction.
Minor Descriptors (MN): Stoma. Activities of Daily Living. Guidelines. Prevention. Food. Dietary Fiber. Symptoms.
Verification/Update Date (VE): 199704.
Notes (NT): CP: Yes.

Accession Number (AN): DD DC 05755.
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37. Anorectal Malformations in Children.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): EN.

Year Published (YR): 1997.
Audience code (AC): HEALTH PROFESSIONALS (100). PATIENT (400).
Author (AU): Pena, A.
Source (SO): Ostomy Quarterly. 34(2): 24-25. March 1997.
Availability (AV): Available from Ostomy Quarterly. 36 Executive Park, Suite 120, Irvine, CA 92614-6744. (800) 826-0826 or (714) 660-8624.
Abstract (AB): This article covers the prognosis and management of anorectal malformations in children. Topics include neonatal management, the decision for colostomy or no colostomy (typically taken within the first 24 hours of life), main repair (posterior sagittal anorectoplasty), colostomy closure, toilet training, and the indications for reoperations. Most patients with anorectal malformations must have a colostomy as a first therapeutic step. The purpose of the colostomy is to save the baby’s life, to allow decompression of the abdomen by passing stool, and subsequently, the colostomy will serve the purpose of protecting the main repair of the rectum that will be performed in a clean environment without the passage of stool. The author then describes the posterior sagittal anorectoplasty technique. The author stresses that the main goal of any technique for the permanent treatment of anorectal malformations is to place the rectum within the sphincteric mechanism to give the patient the opportunity to use his or her sphincter to have bowel control. The article concludes with the contact information for the United Ostomy Association’s Pull-thru Network.

Major Descriptors (MJ): Digestive System Diseases. Colostomy. Children. Infants. Abnormalities. Anorectal Disease.
Minor Descriptors (MN): Congenital Disorders. Surgical Techniques. Surgery. Patient Selection. Postoperative Care. Parent Education. Postoperative Complications.
Verification/Update Date (VE): 199707.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 05902.
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38. Pursuit of Colostomy Continence.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).
Language(s) (LG): EN.
Year Published (YR): 1997.
Audience code (AC): HEALTH PROFESSIONALS (100).

Author (AU): Roberts, D.J.
Series (SE): (Ostomy Care).
Source (SO): Journal of WOCN. Journal of the Wound, Ostomy and Continence Nurses Society. 24(2): 92-97. March 1997.
Availability (AV): Available from Journal of WOCN, Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 453-4351 or (314) 453-4351.
Abstract (AB): The lifelong management required by patients with permanent colostomies leads to dissatisfaction with quality of life for many. Through the years, multiple techniques have been attempted to improve the quality of life by pursuing colostomy continence. This article describes some of these endeavors, including surgical interventions, nonsurgical devices and management (including the practice of irrigation), and behavior modification techniques. Selection criteria have been developed to predict successful management of a colostomy by irrigation. The author cautions that the time necessary to maintain irrigation schedules may be seen as a deterrent to this method (up to 1 hour per day may be required). The author also notes that, when nonsurgical methods are compared on the basis of degree of continence realized, the risk of complications, and ease of use, the colostomy plug offers significant advantages. Although the costs are higher than some other methods, the positive impact of the increased continence associated with use of the colostomy plug on self-esteem, on social and intimate relationships, and on the anxiety associated with fear of odor or an incontinent episode may provide a compelling reason for a patient to assume the additional costs of the device. Efforts in research and development continue, and the desire to achieve continence of the stoma remains a common goal among persons with an ostomy and those involved in their care.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Ostomy Supplies. Fecal Incontinence. Prevention.

Minor Descriptors (MN): Equipment and Supplies. Surgical Techniques. Behavior Modification. Risk Factors. Complications. Costs. Psychosocial Factors. Self Care.
Verification/Update Date (VE): 199707.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 05909.
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39. Significance of Culture in the Care of the Client with an Ostomy.

Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Zoucha, R.; Zamarripa, C.

Series (SE): (Ostomy Care).
Source (SO): Journal of Wound, Ostomy and Continence Nurses. 24(5): 270-276. September 1997.
Availability (AV): Available from Journal of WOCN, Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 453-4351 or (314) 453-4351.
Abstract (AB): Culture is an inextricable part of the fabric that defines each human as an individual, a family member, and a member of local, national, and global communities. This article describes a nursing theory that supports the significance of culture as an essential concept of nursing practice. To illustrate the applicability of these concepts to wound and ostomy care (WOC) nursing practice, the authors present a case study of a Mexican American client with an ostomy. The American dominant cultural values are identified as (but not limited to) an ideal of optimal health, freedom and democracy, individualism, achieving and doing, cleanliness, a goal-oriented respect for time, and value of technology and automation. These values may be in direct conflict with cultural values identified in some cultures of present-time orientation, respect, family and kinship importance, gender roles, and personal space. Cultural relativism is defined as the belief or concept that various approaches to health have merit and are acceptable for each culture because each belief is judged on its own terms and the members’ own perceptions, feelings, and rationale. The authors caution that, without knowing or understanding the cultural care values of each patient, professional nurses may impose their own values, providingculturally incongruent and therefore less effective care. The case study presented offers a description of the family, the assessment, technological factors, religious factors, kinship factor, cultural value factors, political factors, economic factors, educational factors, diverse health care systems, and the plan for culturally congruent nursing care. The authors conclude that the role of the WOC nurse can be that of cultural bridge between professional care and folk care. 18 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Cultural Influences. Ethnic Groups. Nursing Care. Delivery of Health Care. Professional-Patient Relations.
Minor Descriptors (MN): Hispanics. Family. Health Beliefs. Patient Care Management. Patient Education.

Verification/Update Date (VE): 199801.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 06269.
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40. Managing Your Colostomy.
Subfile: Digestive Diseases

Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Hollister Incorporated.
Series (SE): (Patient Education Series).

Source (SO): Libertyville, IL: Hollister Incorporated. 1997. 12 p.
Availability (AV): Available from Hollister Incorporated. 2000 Hollister Drive, Libertyville, IL 60048. (800) 323-4060. Fax (847) 918-3994. PRICE: Single copy free. Also available for free at www.holister.com/educatio/educatio.htm.
Abstract (AB): This patient education booklet provides information for patients about managing a colostomy. The booklet answers some common questions about colostomy surgery and eases concerns about living with a colostomy. The booklet first reviews the anatomy and functions of the human digestive system, focusing on the intestines. A colostomy is a surgically created opening into the colon, through the abdomen. The purpose of a colostomy is to allow stool to bypass a diseased or damaged part of the colon. To construct a colostomy, the surgeon brings part of the person’s colon through the abdominal wall; this new opening on the abdomen is called a stoma. The booklet outlines four types of colostomies: ascending, transverse, descending, and sigmoid, and illustrates each type. Odor is a major concern for people who are about to have colostomy surgery; the booklet reviews steps that can be taken to lessen the odor problem. The booklet encourages readers to eat a balanced, nutritional diet and to be aware of particular foods that may cause a problem for them (foods that form gas, specifically). The booklet discusses diarrhea and how to handle it, medications and their potential side effects on the stool, the use of colostomy irrigation (which allows the person to control when to have a bowel movement), bathing or showering, skin care, clothing, rehabilitation issues (including returning to work and traveling), exercise and sports, and sex and personal relationships. The booklet includes a pocket inside the back cover, with cards for patient’s individual discharge information, a summary of tips regarding when to contact a health care provider, and a list of support and resource organizations. 7 figures.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Lifestyle. Activities of Daily Living. Postoperative Care. Postoperative Complications.
Minor Descriptors (MN): Psychosocial Factors. Diarrhea. Drug Effects. Rehabilitation. Exercise. Travel. Skin Care. Patient Education. Sexuality. Interpersonal Relations. Food. Nutrition. Surgical Techniques.
Verification/Update Date (VE): 200001.

Notes (NT): CP: Yes.
Accession Number (AN): DD BR 07271.
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41. Managing Your Ileostomy.
Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).

Language(s) (LG): English.
Year Published (YR): 1997.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Hollister Incorporated.
Series (SE): (Patient Education Series).
Source (SO): Libertyville, IL: Hollister Incorporated. 1997. 12 p.

Availability (AV): Available from Hollister Incorporated. 2000 Hollister Drive, Libertyville, IL 60048. (800) 323-4060. Fax (847) 918-3994. PRICE: Single copy free. Also available for free at www.holister.com/educatio/educatio.htm.
Abstract (AB): This patient education booklet provides information for patients about managing an ileostomy. The booklet answers some common questions about ileostomy surgery and eases concerns about living with an ileostomy. The booklet first reviews the anatomy and functions of the human digestive system, focusing on the intestines. An ileostomy is a surgically created opening into the small intestine, through the abdomen. The purpose of an ileostomy is to allow stool to bypass a diseased or damaged part of the colon. To construct an ileostomy, the surgeon brings part of the person’s small intestine (ileum) through the abdominal wall; this new opening on the abdomen is called a stoma. The booklet notes that determining where the stoma will be placed on the abdomen is a very important part of the preparations for surgery. Generally, an ileostomy stoma is located on the abdomen in the lower right quadrant. The stool from an ileostomy comes directly from the small intestine, so the stool contains digestive enzymes that can be very irritating to the skin. Because of that, the pouch that is worn must have a protective skin barrier to fit around the stoma. Odor is a major concern for people who are about to have ileostomy surgery; the booklet reviews steps that can be taken to lessen the odor problem. The booklet encourages readers to eat a balanced, nutritional diet and to be aware of particular foods that may cause a problem for them (foods that form gas, specifically). The booklet discusses diarrhea and how to handle it, medications and their potential side effects on the stool, bathing or showering, skin care, clothing, rehabilitation issues (including returning to work and traveling), exercise and sports, and sex and personal relationships. The booklet includes a pocket inside the back cover, with cards for patient’s individual discharge information, a summary of tips regarding when to contact a health care provider, and a list of support and resource organizations. 5 figures.
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Lifestyle. Activities of Daily Living. Postoperative Care. Postoperative Complications.
Minor Descriptors (MN): Psychosocial Factors. Diarrhea. Drug Effects. Rehabilitation. Exercise. Travel. Skin Care. Patient Education. Sexuality. Interpersonal Relations. Food. Nutrition. Surgical Techniques.
Verification/Update Date (VE): 200001.
Notes (NT): CP: Yes.

Accession Number (AN): DD BR 07272.
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42. Don’t Die of Embarrassment: Life After Colostomy and Other Adventures.
Subfile: Digestive Diseases
Format (FM): MONOGRAPH/BOOK (32).
Language(s) (LG): English.

Year Published (YR): 1997.
Audience code (AC): PATIENT (400).
Author (AU): Barrie, B.
Source (SO): New York, NY: Simon and Schuster. 1997. 256 p.
Availability (AV): Available from Simon and Schuster. Mail Order, 100 Front Street, Riverside, NJ 08075. (800) 331-6531. E-mail: Consumer.CustomerService@simonandschuster.com. Website: www.simonsays.com. PRICE: $12.00 plus shipping and handling. ISBN: 0684846241.
Abstract (AB): When the successful actress Barbara Barrie received a diagnosis of colorectal cancer in 1993, she knew that this was the greatest crisis she and her family would face. But it also became an adventure that, through courage and humor, brought new joys and a greater appreciation to her life. More than just a memoir, this book provides valuable information about the ostomy experience. Throughout the book, Barrie gives essential information about the occurrence of colon cancer, its symptoms, and treatment options, and guidelines for people learning to adjust to an altered lifestyle after surgery. The book is written in a conversational, story style, with Barrie sharing her thoughts and fears. The book includes an afterword, written by Dr. Otis W. Brawley, that offers some practical information about diagnosis, screening, warning signs, prevention, and treatment of colon cancer. The book concludes with a chapter describing additional sources of information, and a subject index.

Major Descriptors (MJ): Digestive System Diseases. Colostomy. Colon Cancer. Biography. Psychosocial Factors.
Minor Descriptors (MN): Patient Education. Self Care. Patient Care Management. Diagnosis. Surgery. Postoperative Care. Interpersonal Relations. Emotions. Coping. Symptoms. Therapy.
Verification/Update Date (VE): 200007.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 07660.
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43. Ostomy, Colostomy, Ileostomy. [Ostomia, Colostomia, Ileostomia].
Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English. Spanish.
Year Published (YR): 1996.
Audience code (AC): PATIENT (400).

Corporate Author (CN): Chek-Med Systems, Inc.
Series (SE): (Meducate Patient Education Pamphlets).
Source (SO): Camp Hill, PA: Chek-Med Systems, Inc. 1996. 2 p.
Availability (AV): Available from Chek-Med Systems, Inc. 200 Grandview Avenue, Camp Hill, PA 17011. (800) 451-5797. Fax (717) 761-0216. PRICE: $22 per pack of 50 pamphlets for order of 3-10 packs; 3 packet minimum. Discounts available for larger quantities and complete kits of gastroenterology pamphlets.
Abstract (AB): This patient brochure, available in English and Spanish, provides information about ostomy, colostomy, and ileostomy. All of these are surgical procedures performed to correct a severe disorder of the gastrointestinal tract. An ostomy is an artificial opening in the abdominal wall through which waste from the bowel or urinary tract can be eliminated from the body; a colostomy is an opening made from the colon; an ileostomy involves bringing the ileum (last portion of the small bowel) to the abdominal surface. Information is provided on why an ostomy is performed, psychological factors associated with an ostomy, and the appliances used. Practical guidelines for living with an ostomy are included. It is argued that, contrary to common fears, an ostomy usually improves the quality of life for the patient by correcting a serious or debilitating condition.
Major Descriptors (MJ): Ostomy. Colostomy. Ileostomy. Surgery.

Minor Descriptors (MN): Psychological Factors. Equipment and Supplies. Quality of Life. Gastrointestinal Diseases.
Verification/Update Date (VE): 199611.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 01143.
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44. Colostomy.

Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 1996.
Audience code (AC): GENERAL PUBLIC (300). PATIENT (400).
Author (AU): Carlson, K.J.; Eisenstat, S.A.; Ziporyn, T.

Source (SO): In: Carlson, K.J.; Eisenstat, S.A.; Ziporyn, T. Harvard Guide to Women’s Health. Cambridge, MA: Harvard University Press. 1996. p. 164-165.
Availability (AV): Available from Harvard University Press. Customer Service Department, 79 Garden Street, Cambridge, MA 02138. (800) 448-2242. Fax (800) 962-4983. PRICE: $24.95 (paperback). ISBN: 0674367693 (paperback).
Abstract (AB): This chapter on colostomy is from a consumer handbook on women’s health. The chapter explains when colostomy surgery may be necessary, how the procedure is performed, what happens after the surgery, possible complications, and risk factors. The authors also discuss postoperative problems with sexual dysfunction, and pregnancy and childbearing in women who have had a colostomy. The chapter concludes with a reference to related chapters in the book.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Surgery. Patient Selection. Patient Education.
Minor Descriptors (MN): Risk Factors. Postoperative Care. Postoperative Complications. Pregnancy. Surgical Techniques.
Verification/Update Date (VE): 199610.

Notes (NT): CP: Yes.
Accession Number (AN): DD BK 05443.
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45. Pelvic Pouch Procedure and Continent Ostomies: Overview and Controversies.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).

Language(s) (LG): English.
Year Published (YR): 1996.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Hull, T.L.; Erwin-Toth, P.
Source (SO): Journal of WOCN. Journal of the Wound, Ostomy and Continence Nurses Society. 23(3): 156-165. May 1996.
Availability (AV): Available from Journal of WOCN, Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 453-4351 or (314) 453-4351.

Abstract (AB): The pelvic pouch and the continent ostomy provide reservoirs for fecal contents and avoid the need for traditional pouches. Patients with ulcerative colitis or familial polyposis coli now have the option of undergoing one of these procedures rather than a traditional ostomy. The authors of this article describe both procedures and cover preoperative and postoperative management, with emphasis on coordinated management by the ET nurse and surgeon. The authors conclude that, in carefully selected patients, a pelvic pouch or continent ileostomy provides an appropriate and potentially successful surgical option. A multidisciplinary approach is recommended as facilitating the most positive outcome. 9 figures. 2 tables. 9 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Ileoanal Reservoir. Ileal Pouch. Ileostomy. Nursing Care. Surgical Techniques.
Minor Descriptors (MN): Preoperative Care. Postoperative Care. Patient Care Management. Patient Education. Colitis, Ulcerative. Familial Polyposis. Surgery.
Verification/Update Date (VE): 199701.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 05549.

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46. Developmental Effects on the Adolescent of a Temporary Ileostomy.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24). REVIEW (46).
Language(s) (LG): English.
Year Published (YR): 1996.

Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Manworren, R.C.B.
Source (SO): Journal of WOCN. Journal of the Wound, Ostomy and Continence Nurses Society. 23(4): 210-217. July 1996.
Availability (AV): Available from Journal of WOCN, Mosby-Year Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 453-4351 or (314) 453-4351.
Abstract (AB): This article describes how a temporary ileostomy can interfere with the adolescent’s ability to master developmental tasks. The author presents initial findings from semistructured interviews of four teenage boys. These interviews provide evidence of the effects of a temporary ileostomy on an adolescent’s psychosocial development. Topics include body image, socialization, independence, and sexual identity. 2 tables. 20 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Adolescents. Psychosocial Factors.

Minor Descriptors (MN): Child Development. Psychological Factors. Self Care. Chronic Disease. Sexuality.
Verification/Update Date (VE): 199701.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 05613.
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47. Sexuality and the Stoma: Helping Patients to Cope.

Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).
Language(s) (LG): English.
Year Published (YR): 1996.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): MacArthur, A.

Source (SO): Nursing Times. 92(39): 34-35. September 25, 1996.
Abstract (AB): This article explores the possible effects a stoma can have on patients’ sexuality. The author describes physical and psychological factors that may lead to problems and the implications for nursing practice. The author notes that recognition of sexuality has become part of the holistic approach to patient care and is reflected in many nursing models. Topics include: changes in sexual role and functioning in stoma patients; the effects of a stoma on women’s sexuality; self-concept and self-esteem issues; the impact on homosexual men; positive changes associated with a stoma, particularly for those people with ulcerative colitis; and implications for nursing practice. The author concludes that nurses need to recognize human sexuality as a complex and highly charged issue in order to be able to deal with patients’ sexuality more effectively. 16 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Stoma. Ileostomy. Colostomy. Sexuality. Nursing Care.
Minor Descriptors (MN): Patients. Sex Behavior. Sexual Intercourse. Psychosocial Factors. Male. Female. Patient Care Management. Patient Education. Colitis, Ulcerative.
Verification/Update Date (VE): 199701.
Notes (NT): CP: Yes.

Accession Number (AN): DD JA 05671.
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48. Going for Bowel Surgery.
Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.

Year Published (YR): 1996.
Audience code (AC): PATIENT (400).
Author (AU): Cowart, P.A.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 1996. 16 p.
Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road NE, Suite 110, Atlanta, GA 30340-3079. (800) 241-4925. World Wide Web: http://www.p-h.com/. PRICE: $4.50 plus shipping (retail); $1.95 plus shipping (wholesale to health professionals).
Abstract (AB): This booklet prepares people for what to expect before, during, and after bowel surgery. Topics include the basic digestive system; anostomoses, ileostomies, and colostomies; tests, medicines, consent forms, and bowel preps; what to take to the hospital; and what to expect after surgery and during recovery. The author offers tips for a healthy diet, a safe recovery, and when to contact a health care provider. The brochure includes blank space for readers to record their questions to their health care providers, as well as a list of four resource organizations which readers can contact for more information. The booklet is written at a low reading level in large, clear type. Colorful illustrations depict many of the concepts and techniques discussed. (AA-M).

Major Descriptors (MJ): Digestive System Diseases. Surgery. Patient Education. Colostomy. Ileostomy. Anostomosis.
Minor Descriptors (MN): Postoperative Complications. Postoperative Care. Preoperative Care. Diet Therapy. Nutrition. Symptoms. Diagnostic Tests. Drug Therapy.
Verification/Update Date (VE): 199704.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 05743.
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49. You Have a Colostomy.
Subfile: Digestive Diseases
Format (FM): BROCHURE (08).
Language(s) (LG): English.
Year Published (YR): 1996.
Audience code (AC): PATIENT (400).

Corporate Author (CN): Pritchett and Hull Associates, Inc.
Source (SO): Atlanta, GA: Pritchett and Hull Associates, Inc. 1996. 16 p.
Availability (AV): Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, NE, Suite 110, Atlanta, GA 30340. (800) 241-4925. PRICE: $1.45 each.
Abstract (AB): This brochure provides basic information for people who have just received a colostomy. The brochure, written in nontechnical language, encourages readers to learn how to care for their colostomy and to take an active part in their return to good health. The brochure lists and illustrates the four types of colostomies: ascending, transverse, descending, and sigmoid. The brochure then outlines pouch and skin care, including emptying and changing the pouch, the use of an emergency kit, tips for pouch care, and when to contact a health care provider to help manage skin problems. One section describes the use of irrigation, or an enema through the stoma. The brochure concludes with a section on diet, including lists of foods that may cause gas, foods that may thicken the stool, and foods that may loosen the stool. The back cover of the brochure lists contact information for the United Ostomy Association, and the Wound, Ostomy and Continence Nurses Society. The brochure is illustrated with line drawings.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Self Care. Skin Care. Ostomy Supplies.
Minor Descriptors (MN): Patient Education. Colon. Physiology. Stoma. Equipment and Supplies.

Verification/Update Date (VE): 200308.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 06477.
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50. Guide to Living with a Colostomy.
Subfile: Digestive Diseases

Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.
Year Published (YR): 1996.
Audience code (AC): PATIENT (400).
Corporate Author (CN): Canadian Association for Enterostomal Therapy (CAET).
Source (SO): Ottawa, ON: Canadian Association for Enterostomal Therapy. 1996. 19 p.

Availability (AV): Available from Canadian Association for Enterostomal Therapy (CAET). C/O Canadian Nurses Association, 50 The Driveway, Ottawa, ON K2P 1E2. Website: www.caet.ca. PRICE: Contact publisher for price.
Abstract (AB): A colostomy is a surgically created opening into the colon. This booklet provides information for patients adjusting to living with a colostomy. The booklet begins with a description of the anatomy and function of the digestive tract and the colon in particular. The booklet then discusses the different types of colostomies, the stoma and different types of colostomy stomas (end colostomy, end colostomy with a mucus fistula or rectal stump, loop colostomy); the pouching systems that are used to contain stool, odor, and gas, and to protect the skin; preoperative preparation; postoperative expectations; colostomy irrigations; gaining independence postoperatively; discharge from the hospital; resuming one’s lifestyle (including sexual relations, work, activities, bathing, clothing, and travel); medications; skin care; dietary management (handling excessive gas, odor, diarrhea, and constipation); and postsurgical visits to the health care provider. The booklet concludes with a glossary of related terms, a list of the task force members who participated in the creation of the booklet, and a list of Canadian resources through which readers can obtain additional information. Blank space is available for listing the telephone numbers of the reader’s health care providers. 6 figures.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Postoperative Care. Adjustment. Activities of Daily Living.
Minor Descriptors (MN): Patient Education. Preoperative Care. Postoperative Complications. Diet. Diarrhea. Constipation. Flatulence. Prevention. Self Care. Psychosocial Factors. Coping. Ostomy Supplies.
Verification/Update Date (VE): 200007.
Notes (NT): CP: Yes.

Accession Number (AN): DD BR 07682.
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51. Ostomy: Questions and Answers.
Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.

Year Published (YR): 1996.
Audience code (AC): PATIENT (400).
Corporate Author (CN): American Society of Colon and Rectal Surgeons.
Source (SO): Arlington Heights, IL: American Society of Colon and Rectal Surgeons (ASCRS). 1996. [2 p.].
Availability (AV): Available from American Society for Colon and Rectal Surgeons (ASCRS). 85 West Algonquin Road, Suite 550, Arlington Heights, IL 60005. (800) 791-0001 or (847) 290-9184. PRICE: Single copy free. Also available for free at www.fascrs.org.
Abstract (AB): This brochure describes ostomies, which are defined as surgically created openings connecting an internal organ to the surface of the body. The most common types of ostomies in intestinal surgery are an ileostomy (connecting the small intestine to the skin) and a colostomy (connecting the large intestine to the skin). An ostomy may be temporary or permanent. A temporary ostomy may be required if the intestinal tract can’t be properly prepared for surgery because of blockage by disease or scar tissue, or if a disease process or operative site needs to heal without irritation by the passage of stool. A permanent ostomy may be required when disease, or its treatment, impairs normal intestinal function, or when the muscles that control the rectum do not work properly or require removal. The most common causes of these conditions are low rectal cancer and inflammatory bowel disease. After the ostomy has been placed, the surgeon or enterostomal therapy (ET) nurse will teach the patient how to apply and wear a pouch called an ostomy appliance. The pouch is made of a special form of plastic that is held to the body with an adhesive skin barrier. The frequency of bowel movements will vary, depending on the type of ostomy, diet, and bowel habits prior to surgery. Physical activities, including active sports, may be resumed once healing from surgery is complete. Most patients with ostomies resume their usual sexual activity. The brochure notes that it is often comforting and reassuring for a patient who is facing a permanent ostomy to visit with another person who has already been through the surgery and adjusted to his or her ostomy. The brochure concludes with a brief description of the work and training of the colon and rectal surgeon.

Major Descriptors (MJ): Digestive System Disease. Ostomy. Colostomy. Ileostomy. Etiology. Patient Selection. Postoperative Care. Quality of Life.
Minor Descriptors (MN): Patient Education. Self Care. Ostomy Supplies. Nursing Care. Defecation. Activities of Daily Living. Psychosocial Factors. Adjustment.
Verification/Update Date (VE): 200101.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 07954.
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52. You and Your Ileostomy: Simple Explanations of Psychological and Physical Problems. Revised edition.
Subfile: Digestive Diseases
Format (FM): BOOK/MONOGRAPH (32).
Language(s) (LG): English.
Year Published (YR): 1995.
Audience code (AC): PATIENT (400).

Author (AU): Gill-Thompson, N.N.; Thompson, S.J.
Series (SE): (Ostomy Series).
Source (SO): Akron, OH: Worldwide Home Health Center. 1995. 134 p.
Availability (AV): Available from Worldwide Home Health Center. 926 East Tallmadge Avenue, Akron, OH 44310. (800) 621-5938 or (330) 633-0366. PRICE: $12.00 plus $4.00 shipping and handling.
Abstract (AB): This book provides basic information for the person contemplating ileostomy surgery. The authors also provide information appropriate for those persons who have recently had ileostomy surgery. Twelve chapters cover topics including anatomy and ostomy surgery, an introduction to the equipment used, information about appliances, odor barriers, skin problems, food blockage, everyday living with an ileostomy, sources of help, and professional and volunteer organizations. In addition, a manufacturers index and glossary are included. The book is spiral-bound to facilitate updates. Photographs and drawings illustrate the concepts presented. 13 references.
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Patient Education. Equipment and Supplies.

Minor Descriptors (MN): Ostomy Supplies. Psychosocial Factors. Activities of Daily Living. Skin Care.
Verification/Update Date (VE): 199608.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 03117.
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53. You and Your Colostomy: Simple Explanations of Psychological and Physical Problems. Revised edition.

Subfile: Digestive Diseases
Format (FM): BOOK/MONOGRAPH (32).
Language(s) (LG): English.
Year Published (YR): 1995.
Audience code (AC): PATIENT (400).
Author (AU): Gill-Thompson, N.N.; Thompson, S.J.

Series (SE): (Ostomy Series).
Source (SO): Akron, OH: Worldwide Home Health Center, Inc. 1995. 135 p.
Availability (AV): Available from Worldwide Home Health Center. 926 East Tallmadge Avenue, Akron, OH 44310. (800) 621-5938 or (330) 633-0366. PRICE: $12.00 plus $4.00 shipping and handling.
Abstract (AB): This book provides basic explanations of psychological and physical issues that may face persons with colostomies. Seventeen chapters cover an introduction, colostomy types, post-operative care, care of the colostomy, information about appliances, deciding about irrigation, irrigation of the colostomy (enema), odor barriers, skin problems, miscellaneous problems that might be encountered, miscellaneous information for the person with a colostomy, nutrition, everyday living with a colostomy, sources of help, professional and volunteer organizations, a manufacturer’s index, and a glossary. The book is written in an easy-to-read, friendly style, with line drawings and photographs illustrating many of the concepts presented. The book is spiral bound to facilitate updates. 14 references.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Patient Education.
Minor Descriptors (MN): Ostomy. Equipment and Supplies. Activities of Daily Living. Nutrition. Self Care. Skin Care. Psychosocial Factors. Ostomy Supplies.

Verification/Update Date (VE): 199608.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 03127.
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54. Paediatric Ileostomy Patients Can Eat Virtually Anything.
Subfile: Digestive Diseases

Format (FM): NEWSLETTER ARTICLE (35).
Language(s) (LG): English.
Year Published (YR): 1995.
Audience code (AC): PATIENT (400).
Author (AU): Rogers, J.
Series (SE): (Practical Advice).

Source (SO): Messenger: Newsletter of the American Pseudo-Obstruction and Hirschsprung’s Disease Society, Inc. 7(2): 7. Summer 1995.
Availability (AV): Available from APHS. 158 Pleasant Street, North Andover, MA 01845-2797. (508) 685-4477. Fax (508) 685-4488. E-mail: aphs@mail.tiac.net.
Abstract (AB): This brief newsletter article discusses dietary concerns that one may encounter in a child with an ileostomy. The author stresses that if the child with an ileostomy has no other medical problems, a normal balanced diet appropriate to their age is recommended. The author, a pediatric nurse, goes on the encourage parents and provide guidelines for introducing new foods and maintaining a healthy diet in these children. Topics include determining which foods should be excluded from the diet; problems with constipation, diarrhea, and increased odor; problems encountered with an artificial sweetener, sorbitol; ways to reduce or manage odor problems; the absorption of food and nutrients; ensuring adequate fluid intake; and psychosocial and quality of life considerations. 4 references.
Major Descriptors (MJ): Digestive System Diseases. Ileostomy. Diet Therapy. Guidelines.
Minor Descriptors (MN): Postoperative Care. Children. Constipation. Diarrhea. Prevention. Flatulence. Fluids. Psychosocial Factors. Quality of Life.
Verification/Update Date (VE): 199705.

Notes (NT): CP: Yes.
Accession Number (AN): DD JA 05046.
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55. Trends in Pediatric Ostomy Surgery: Intestinal Diversion for Necrotizing Enterocolitis and Biliary Diversion for Biliary Hypoplasia Syndromes.
Subfile: Digestive Diseases
Format (FM): JOURNAL ARTICLE (24).

Language(s) (LG): English.
Year Published (YR): 1995.
Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): Bastawrous, A.A.L., et al.
Source (SO): Journal of WOCN. 22(6): 280-285. November 1995.
Availability (AV): Available from Mosby Year-Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-3318. (800) 453-4351 or (314) 453-4351.

Abstract (AB): Many ostomies of childhood are placed because of congenital or neonatal problems that require temporary or long-term diversion to stabilize the neonatal patient. This article reviews current information on biliary cutaneous diversion for the biliary hypoplasia syndromes and intestinal diversion for necrotizing enterocolitis. The authors note that necrotizing enterocolitis, the most common reason for placement of neonatal colostomies and ileostomies, is increasing in frequency as more premature infants survive. Children with biliary hypoplasia syndromes are a challenging group of patients who frequently can be helped by ostomies. The authors also note that the type of diversion used varies with the pathologic defect, the tissue available, the specific disease process, and the surgeon’s preference. 4 figures. 1 table. 11 references. (AA-M).
Major Descriptors (MJ): Digestive System Diseases. Infants. Colostomy. Ileostomy. Biliary Tract Diseases. Colitis. Surgery.
Minor Descriptors (MN): Surgical Techniques. Symptoms. Patient Selection. Newborn.
Verification/Update Date (VE): 199604.
Notes (NT): CP: Yes.
Accession Number (AN): DD JA 05146.

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56. Recent Advances in Colostomy Care.
Subfile: Digestive Diseases
Format (FM): BOOK CHAPTER (09).
Language(s) (LG): English.
Year Published (YR): 1995.

Audience code (AC): HEALTH PROFESSIONALS (100).
Author (AU): De-hong, Y.
Series (SE): (Proceedings of the Patient Education 2000 Congress, Geneva, Switzerland, 1-4 June 1994).
Source (SO): In: Assal, J., Golay, A., and Visser, A.P., eds. New Trends in Patient Education: A Trans-Cultural and Inter-Disease Approach. Amsterdam, The Netherlands: Elsevier Science B.V. 1995. p. 349-352.
Availability (AV): Available from Elsevier Science. Regional Sales Office, Customer Support Department, 655 Avenue of the Americas, New York, NY 10010. (212) 633-3730. Fax (212) 633-3680. E-mail: usinfo-f@elsevier.com. PRICE: $209.50. ISBN: 0444822348.
Abstract (AB): This chapter, from the proceedings of an international patient education conference, describes recent advances in colostomy care. The author discusses three kinds of stoma care, paying particular attention to several advances and setbacks. These include the natural evacuation method, the irrigation management of sigmoid colostomy, and the Conseal Colostomy Plug. The chapter describes special conditions of colostomy care in China. 2 tables. (AA-M).

Major Descriptors (MJ): Digestive System Diseases. Colostomy. Equipment and Supplies. Patient Education.
Minor Descriptors (MN): Delivery of Health Care. Inflammatory Bowel Disease. Colostomy. Self-Care. Cultural Influences. International Health.
Verification/Update Date (VE): 199701.
Notes (NT): CP: Yes.
Accession Number (AN): DD BK 05618.
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57. Colostomy: An Introduction.
Subfile: Digestive Diseases
Format (FM): BROCHURE/PAMPHLET (08).
Language(s) (LG): English.
Year Published (YR): 1995.
Audience code (AC): PATIENT (400).

Corporate Author (CN): United Ostomy Association.
Source (SO): Irvine, CA: United Ostomy Association. 1995. 2 p.
Availability (AV): Available from United Ostomy Association. Attn: Publications, 19772 MacArthur Boulevard, Suite 200, Irvine, CA 92612. (800) 826-0826 or (714) 660-8624. E-mail: uoa@deltanet.com. PRICE: $0.25 each.
Abstract (AB): This brochure provides basic information for people who have just received or who are about to receive a colostomy. A colostomy is an opening in the abdominal wall through which digested food passes. A colostomy may be performed when a diseased or injured colon cannot be treated successfully with medicine. The brochure describes the various conditions that may result in the need for a colostomy. The brochure then describes the differences between a temporary and a permanent colostomy. Digested food, which passes through the stoma (opening), is collected in a device called a pouch or an appliance. Appliances today are not bulky, are odor-free, and come in a variety of disposable or reusable varieties to fit different lifestyles. The brochure then addresses possible changes in one’s life after the colostomy in the areas of work, sex and social life, and sports and activities. The brochure stresses that individuals with ostomies don’t look different or smell bad, so their social lives depend mainly on attitude. The brochure concludes with a section encouraging readers to join the United Ostomy Association (UOA) local chapter and support group. The materials and activities of the UOA are also outlined. 1 figure.
Major Descriptors (MJ): Digestive System Diseases. Colostomy. Patient Education. Patient Selection. Ostomy Supplies. Psychosocial Factors.
Minor Descriptors (MN): Stoma. Equipment and Supplies. Activities of Daily Living. Lifestyle. Quality of Life. Surgery.

Verification/Update Date (VE): 199804.
Notes (NT): CP: Yes.
Accession Number (AN): DD BR 06441.
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