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| List of Contributors | |
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| Acknowledgements | |
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| Preface | |
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| Introduction | |
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| Stomas: The Past, Present and Future | |
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| Introduction | |
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| The history of stomas | |
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| Stomas | |
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| Stoma care nursing | |
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| Roles of the stoma specialist nurse | |
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| Present day stoma care | |
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| Support groups | |
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| The future of stoma care | |
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| References | |
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| Anatomy and Physiology of the Urinary and Gastrointestinal System | |
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| Introduction | |
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| The skin | |
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| Wound healing process | |
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| The abdominal wall | |
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| The peritoneum | |
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| The gastrointestinal tract | |
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| The digestive process | |
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| The bowel wall | |
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| Blood supply | |
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| Lymphatic supply | |
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| Mouth | |
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| Oesophagus | |
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| Stomach | |
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| Small intestine | |
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| Duodenum | |
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| Jejunum and ileum | |
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| Large intestine | |
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| Caecum | |
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| Ascending colon | |
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| Transverse colon | |
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| Descending colon | |
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| Sigmoid colon | |
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| Rectum | |
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| Anal canal | |
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| Accessory organs associated with the GI tract | |
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| The liver | |
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| The gallbladder | |
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| The pancreas | |
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| The spleen | |
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| Urinary system | |
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| References | |
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| Colorectal Cancer and Adjunct Therapy | |
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| Introduction | |
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| Incidence | |
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| Possible causal factors | |
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| Symptoms and clinical presentations | |
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| Assessment, staging investigations and the multidisciplinary team | |
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| Multidisciplinary team | |
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| Pre-operative staging | |
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| Surgery | |
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| Histopathology | |
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| Adjuvant chemotherapy | |
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| Effects of chemotherapy on stomas | |
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| Radiotherapy | |
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| Palliative chemotherapy | |
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| Surveillance and follow-up | |
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| Screening | |
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| Conclusion | |
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| Further information and websites | |
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| References | |
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| Further Reading | |
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| Infl ammatory Bowel Disease | |
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| Introduction | |
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| Croh's disease | |
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| Ulcerative colitis | |
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| Infl ammatory bowel disease statistics | |
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| Signs and symptoms for ulcerative colitis | |
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| Croh's disease: signs and symptoms | |
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| Aetiology of IBD | |
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| Diagnosing IBD | |
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| Medical therapy for IBD | |
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| Dietary therapy for IBD | |
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| Surgery for Croh's disease | |
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| Surgery for ulcerative colitis | |
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| Malignancy in ulcerative colitis | |
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| Malignancy in Croh's disease | |
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| Extra-intestinal manifestations | |
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| Other medical issues in IBD | |
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| Fertility in IBD | |
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| Patient education | |
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| Conclusion | |
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| References | |
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| Familial Adenomatous Polyposis | |
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| Introduction | |
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| The Polyposis Registry and research | |
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| Diagnosing FAP | |
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| Bowel screening of relatives at-risk; | |
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| Surgery | |
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| Colectomy with IRA | |
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| Restorative proctocolectomy | |
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| Total/panproctocolectomy | |
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| Upper GI disease | |
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| Extra-colonic manifestations (ECMs) | |
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| Desmoid disease | |
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| An accessible expert centre | |
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| References | |
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| Continence | |
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| Introduction | |
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| Normal bladder and bowel control | |
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| Risk factors for incontinence | |
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| Obstetric trauma to the pelvic floor | |
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| Age | |
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| Investigations | |
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| Treatment of incontinence | |
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| Practical management | |
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| Surgical interventions | |
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| Conclusion | |
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| Useful websites | |
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| References | |
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| Other Conditions Leading to Stoma Formation | |
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| Introduction | |
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| Congenital malformations/anomalies | |
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| Cystic fi brosis | |
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| Diverticular disease | |
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| Ehlers Danlos | |
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| Gynaecological tumour | |
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| Hereditary non-polyposis colon cancer (HNPCC) | |
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| Hirschsprun's disease | |
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| Interstitial cystitis | |
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| Intussusception | |
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| Irradiation damage | |
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| Ischaemic bowel | |
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| Meconium ileus | |
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| Megarectum | |
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| Necrotising enterocolitis | |
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| Necrotising fasciitis | |
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| Obstruction | |
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| Perforated bowel | |
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| Solitary rectal ulcer | |
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| Spina bifida | |
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| Spinal cord injury | |
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| Trauma | |
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| Visceral myopathy | |
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| Volvulus | |
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| Conclusion | |
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| References | |
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| Surgery | |
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| Introduction | |
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| Temporary stomas | |
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| Permanent stomas | |
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| Stoma formation | |
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| Surgical technique | |
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| Surgical alternatives | |
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| Complications | |
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| Enhanced recovery after surgery (ERAS) | |
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| Conclusion | |
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| References and further reading | |
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| Pre- and Post-operative Care | |
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| Introduction | |
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| Referral to health care professionals | |
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| Pre-operative assessment and investigations | |
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| Pre-operative information | |
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| Bowel preparation | |
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| Meeting another ostomate | |
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| Informed consent | |
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| Stoma siting assessment | |
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| Cultural/religious issues related to siting | |
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| Stoma siting | |
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| Pre-operative fasting | |
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| Post-operative aims | |
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| Post-operative care | |
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| Blood tests | |
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| Nausea and vomiting | |
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| Nutrition | |
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| Post-operative analgesia | |
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| Post-operative exercises | |
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| Post-operative appliances | |
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| Post-operative stoma assessment | |
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| Normal stomas | |
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| Normal stoma outputs | |
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| Post-operative urostomies | |
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| Post-operative faecal stomas | |
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| Wound care | |
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| Post-operative stoma care teaching | |
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| Teaching plan | |
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| Stoma closure | |
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| Small bowel obstruction | |
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| Wound infection | |
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| Abdominal sepsis | |
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| References | |
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| Intestinal Pouches | |
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| Introduction | |
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| The coloanal or colonic Jpouch | |
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| The Kock pouch/reservoir | |
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| The ileoanal pouch | |
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| Patient suitability and selection | |
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| The S;, J or W pouch | |
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| Pre-operative counselling (surgical vs. medical approach) | |
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| Post-operative care | |
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| Anal skin care | |
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| Fertility, pregnancy and childbirth | |
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| Pouch absorption and diet | |
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| Problems following RPC | |
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| Research and current development | |
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| Laparoscopic surgery | |
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| Probiotics | |
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| Quality of life | |
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| Nursing developments | |
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| References | |
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| Urinary Diversion | |
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| Introduction | |
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| Reasons for urinary diversion | |
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| Urostomy | |
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| Colonic conduit | |
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| The ileal conduit | |
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| Internal urinary pouches | |
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| Neobladder | |
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| Urinary drainage | |
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| The Mainz Sigma II pouch (modified ureterosigmoidostomy) | |
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| Support groups | |
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| References | |
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| Appliances | |
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| Introduction | |
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| History of stoma care products | |
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| Modern pouches | |
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| Colostomy appliances | |
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| Ileostomy appliances | |
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| Urostomy appliances | |
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| Additional drainage bags | |
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| One- and two-piece appliances | |
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| Adhesive coupling system | |
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| Toilet fl ushable colostomy appliances | |
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| Stoma caps | |
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| Stoma plug | |
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| Appliances for high-output stomas | |
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| Fistula appliances | |
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| Convex fl anges | |
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| Stoma accessories | |
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| Protective wafers/sheets | |
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| Skin cleansers | |
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| Paste | |
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| Seals and washers | |
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| Flange securing tape | |
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| Ostomy belts | |
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| Adhesive | |
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| Adhesive removers | |
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| Odour treatment options | |
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| Protective powder | |
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| Protective film | |
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| Protective cream | |
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| Pancaking prevention agents | |
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| Discharge solidifying agents | |
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| Pouch clips and soft ties | |
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| Pouch covers | |
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| Flatus fi lters | |
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| Hernia support garments | |
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| Protective shields | |
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| Clothing | |
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| Stoma appliance costing | |
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| Conclusion | |
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| References | |
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| Discharge to the Community | |
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| Introduction | |
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| Discharge criteria | |
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| Stoma supplies | |
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| Disposal of appliances | |
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| Obtaining further supplies | |
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| Nurse prescribing | |
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| Appliances | |
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| Follow-up visits | |
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| Post-operative psychological adjustment | |
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| Returning to work | |
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| Resuming social activities and hobbies | |
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| Exercises | |
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| Driving | |
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| Clothing | |
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| Alcohol | |
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| Support garments | |
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| Travel | |
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| Long-term follow-up | |
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| References | |
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| Nutrition | |
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| Introduction | |
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| Digestion and absorption of nutrients | |
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| The Balance of Good Health; Colostomy | |
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| Dietary management of functional problems post-colostomy formation | |
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| Ileostomy | |
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| Dietary management of functional problems post-ileostomy formation | |
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| Ileoanal pouch | |
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| Dietary management of functional problems post-ileoanal pouch formation | |
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| Urostomy | |
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| Dietary management of functional problems following urostomy formation | |
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| Peri-operative nutrition | |
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| Provision of nutrition support | |
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| Monitoring | |
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| Conclusion | |
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| References | |
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| Further Reading | |
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| Complications | |
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| Introduction | |
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| Short-term complications | |
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| Long-term complications | |
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| Allergy and skin sensitivities | |
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| Bleeding | |
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| Cancer recurrence locally | |
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| Croh's disease | |
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| Constipation | |
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| Diarrhoea | |
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| Discolouration of the stoma | |
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| Flatus | |
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| Granulomas/overgranulation | |
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| Hernia | |
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| High-output stoma | |
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| Ileus paralytic ileus | |
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| Infection | |
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| Melanosis coli | |
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| Mucocutaneous separation | |
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| Necrosis | |
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| Obstruction | |
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| Odour | |
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| Pancaking | |
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| Phantom bladder/rectum | |
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| Prolapse | |
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| Pyoderma gangrenosum | |
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| Retraction | |
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| Skin problems | |
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| Stenosis | |
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| Stoma trauma | |
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| Urine crystal formation | |
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| Varices | |
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| Conclusion | |
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| References | |
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| Fistulae and Intestinal Failure | |
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| Introduction | |
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| Defi ning fi stulae | |
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| Intestinal failure | |
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| Parenteral nutrition (PN) | |
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| Fistuloclysis | |
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| Conclusion | |
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| References | |
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| Bowel Irrigation | |
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| Introduction | |
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| Rectal irrigation | |
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| Colonic irrigation | |
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| Colostomy irrigation | |
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| Travel | |
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| Antegrade colonic enemas (ACEs) | |
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| Percutaneous endoscopic colostomy (PEC) | |
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| Conclusion | |
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| References | |
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| Other Stoma Issues | |
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| Introduction | |
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| Age related issues | |
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| Drugs | |
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| Exercise | |
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| Psychological issues | |
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| Body image | |
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| Sexual issues | |
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| Specialist clothing | |
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| Toilet access | |
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| Cultural issues | |
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| Religious issues | |
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| Travel | |
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| Quality of life | |
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| Conclusion | |
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| References | |
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| Index | |