Effective use of total parenteral nutrition in an ileostomy patient.

Several goals were achieved through nutritional support of a 52-year-old female ileostomy patient who was admitted with dehydration, clinical malnutrition of a kwashiorkor type, and excessive body fat. Initially, parenteral nutrition was used to stabilize the patient. A total parenteral nutrition solution was calculated to meet the patient's energy, protein, mineral, vitamin, and fluid needs, including special needs resulting from the loss of fluid and electrolytes via the ostomy. The patient was subsequently weaned onto enteral feeding and then onto food plus an enteral mineral and vitamin drip. Nutritional status was improved (e.g., positive nitrogen balance was established); the patient absorbed nutrients better; and some lean body mass was restored, while total body weight decreased.