"Terminal ileopathy a common malabsorptive syndrome developing after irradiation treatment for pelvic malignancy and after ileal resection

Patients having had an ileal resection or a significant segment of ileum excluded and used for construction of a continent urinary diversion as well as those in whom radiation treatment of gynaecological , bladder or -rectal cancer have injurred distal small bowel all these patients will develop a characteristic malabsorbtion syndrome, a "terminal ileopathy" Patients often suffer a troublesome and socially inconvenient watery diarrhoea. Apart from vitamine B12-malabsorption which untreated may give rise to megaloblastic anaemia and irreverible neurogenic disturbances the bile salt malabsorption causes a series of other events, the severity of which varies with the magnitude of malabsorbtion.. The condition called “terminal ileopathy” includes a number of malfunctions, such as watery diarrhoea, steathorrhea, hyperoxaluria , malabsorbtion of fat soluble vitamines and minerals. Stoma and urotherapists are those who have a more intimate contact with these patients in the postoperative phase . Their understanding of the malabsoptive syndrome and the underlying pathophysiological mechanism is therefore of special importance and also a prerequisite to a successful management.