Have unfortunate patient with ECF and short bowel syndrome. Curious about role of creon when given together with ONS. Anyone have given it, kindly share your experience.
Appreciate your feedback.
I have not used it, and I don't see the rationale for this therapy in SBS.
Which part of the bowel has been resected?
Optimized medical management, PPI, anti-motility, (high salt-high calorie if small bowel, and low fat-low oxalate if colon), consider Teduglutide (GLP-2) agonist..
For the ECF, it has been reported using (ASD "atrial Septal Defect" occlusion device) successfully in closing the ECF.. This will need an experienced Advanced Endoscopist ..
I hope this helps
Goal of management in entero-cutaneous fistula is to ensure good nutrition (parenteral nutrition) with avoidance of sepsis, drainage of infective / bowel contents, wound healing (vacuum dressing / stoma bag / wound manager). Can even try re feeding the proximal contents into the fistula, if possible.
Cannot see the reason behind usage of creon (pancreatic enzymes used in chronic Pancreatitis) in Ent cut fistula. ONS ? Ondansetron
Octreotide maybe useful in select cases.
Thank you for the feedback. I am hoping for increase nutritional absorption with small ONS feeds and creon.
Yes, maby due to better disolve of nutricional content and consequtive better utilisation in the first place, aminoacids.
Treatment. If the enterocutaneous fistula (ECF) doesn't heal on its own after a few weeks or months, a complex surgery is required to close the fistula and reconnect the gastrointestinal tract. Patients with ECFs often need specialized wound care, nutritional rehabilitation and physical rehabilitation.
An enterocutaneous fistula (ECF) is an abnormal connection that develops between the intestinal tract or stomach and the skin. As a result, contents of the stomach or intestines leak through to the skin. Most ECFs occur after bowel surgery.
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