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Original Question

Mr Dissanayake is a 58 y/o male of Sri-Lankan origin, brought to the emergency department by his son Isuru because he is feeling unwell. Isuru explains that his father has a temporary ileostomy to allow the colon to heal. He had a large section of his colon resected two months ago due to inflammatory bowel disease. Mr Kasun explains in broken English that he has no energy and for the last three days has had “many liquid poo in bag and then out everywhere”, indicating high faecal volume and leakages. Collect cues Vital Signs • RR = 23 bpm • SpO2 = 100% • BP = 95/62 mmHg (MAP 73 mmHg) • HR = 108 bpm • Temp = 37 o C Fluid status assessment • Weak pulses • Pale and cool to the touch • Cap refill >3 sec • Reduced skin turgor • Dry mucous membranes – tongue is furrowed • Last voided – “can’t remember” • Volume of stoma output > 2L/24 hrs • Consistency of effluent – liquid. What is the alteration of digestive system health?

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