Judith Beurskens is a nurse specialist at the Department of Stomach, Bowel and Liver Diseases at Radboud University Medic Center in Nijmegen. "One of the functions of a nurse specialist is that you do research into innovations and set up a project for that," says Judith during a conversation about her research among patients with severe intestinal failure.
The research is aimed at patients being able to measure urine samples independently. The results of this were promising in the first phase. In 2023, the research will enter the clinical phase. Based on an interview with Judith, we would like to tell you more about the first and second phase of this research in four different blogs.
“In people who have a severe form of intestinal failure, the body is no longer able to absorb sufficient fluids or electrolytes and sometimes also nutrients. Those patients have either motility disorders, which means that the stomach or intestine does not knead enough to properly break down the food. Or have a piece of intestine that has been removed (short intestine). Very often these people also have a stoma,” Judith explains the type of patient and the conditions for which she started this research.
“If the stoma is placed very high in the intestines, that is the place where a lot of fluid still passes through the intestines. That is even six to eight litres a day, to crush and take apart that food so that it can also be absorbed further along the course of the intestine,” Judith continues her explanation.
People who have a stoma this high in the intestine therefore lose a lot of fluid and have an extra risk of dehydration. Because of the high output, the stoma is also referred to as a high output stoma. Because these people also lose a lot of electrolytes and nutrients due to this high fluid loss, even before they can be absorbed by the body, they often receive nutrients directly into the bloodstream: Total Parenteral Nutrition (TPV). Or administer extra fluid with electrolytes or sometimes magnesium or phosphates at home via an intravenous drip.
At this point, it is actually the patient who first experiences signs of dehydration. This includes headaches, thirst or even cramps. But that doesn't always have to be a sign of dehydration. It often happens that they do not realize this in time.
This can be detected early by measuring the sodium content in the urine. That is still going through a laboratory test. But if it is up to Judith, patients will measure this themselves from now on with the Fisic Medimate. Read more about the experiences in this article (pdf).