Editing Intestinal Segments and Urinary Diversion (section)

==== <span style="color:#0000ff">M</span><span style="color:#ff0000">alabsorption ====
* '''In patients with a significant loss of ileum, there can be malabsorption of'''
*# '''Vitamin B12 resulting in anemia and neurologic abnormalities'''
*#* '''Since the liver stores enough vitamin B12 to supply the body’s requirement for 3-5 years without oral intake''', pathologic problems would not be expected to manifest themselves for many years
*# '''Bile salts resulting in''' mucosal irritation and '''diarrhea''' because the ileum is the major site of bile salt reabsorption.
*#* '''There are 3 mechanisms of diarrhea in a patient with ileal conduit:'''
*#*# '''Malabsorption of bile salts''' since the ileum is the major site of bile salt reabsorption
*#*# '''Malabsorption of fat''' from loss of “ileal break" and small intestinal bacterial overgrowth from loss of ileocecal valve
*#*## The ileal break is a mechanism whereby gut motility is reduced when lipids come in contact with the ileal mucosa so that increased absorption can occur. With the loss of ileum, the lipid does not result in decreased motility and is presented unmetabolized to the colon, which may cause '''fatty diarrhea.'''
*#*# '''Loss of ileocecal valve'''
*#*#* '''May result in reflux of large concentrations of bacteria into the ileum,''' resulting in small intestinal bacterial overgrowth which may cause nutritional abnormalities that involve '''interference with fatty acid reabsorption and bile salt interaction.'''
*#** '''With the lack of absorption of fats and bile salts, these are presented to the colon and result in diarrhea.'''
* '''Loss of a significant portion of jejunum may result in malabsorption of fat, calcium, and folic acid'''
* '''Loss of the colon may result in diarrhea because of lack of fluid and electrolyte absorption, loss of bicarbonate'''