I have a colostomy, about 1" opening, and for 8 years I had no problem with my pouches. Then for 3 or 4 months I can't seem to have a bag on for more than a day, and there is leakage. What is deep convexity and should I have different kind of pouches that have a deep convexity? Would that help? Thank you.
Understanding the Protein Digestibility Corrected Amino Acid Score (PDCAAS)
- 5/31/2009
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10 Protein metabolism depends on proper digestion where whole protein is hydrolyzed into amino acids. If a patient has poor digestive capacity, provision of a predigested product is the best choice. Targeted amino acids, namely arginine and glutamine, are also widely available for patients who may benefit from specific amino acid therapy.
Protein supplementation is provided in many forms, including traditional canned or bottled beverages, concentrated liquids, and powders. Products are available in individual packs, bulk containers, or bottles and require different amounts of preparation to dispense to patients. Staff effort to prepare the supplement is yet another consideration. If staff do not have time to measure, mix, prepare, store, and serve the supplement properly, regulatory issues may arise, as well as taste and acceptance problems.
Although protein evaluation scores are vitally important to researchers, academicians, and food scientists, healthcare practitioners may find they are better served by viewing the bigger picture of which the PDCAAS score is only one part. Patient acceptance, flavor, form, volume, digestibility, ease of preparation, and cost all play a role in protein selection. Having a variety of products available will help meet all patients’ needs and preferences in this era of individualized care.
This article was not subject to the Ostomy Wound Management peer-review process. Nancy Collins, PhD, RD, LD/N, FAPWCA, is founder and executive director of RD411.com and Wounds411.com. For the past 20 years, she has served as a consultant to healthcare institutions and as a medico-legal expert to law firms involved in healthcare litigation. Correspondence may be sent to Dr. Collins at NCtheRD@aol.com.
References:
1. Castellanos VH, Litchford MD, Campbell WW. Modular protein supplements and their application to long-term care. Nutr Clin Pract. 2006;21(5):485–504.
2. Schaafsma G. The protein digestibility-corrected amino acid score. J Nutr. 2000;130(7):1865S–1867S.
3. National Academy of Sciences, Institute of Medicine, Food and Nutrition Board. Protein and amino acids. In: Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids: Food and Nutrition Board: National Academy of Sciences. Washington, DC: National Academy Press;2005.
4. FAO/WHO Expert Consultation. Protein Quality Evaluation: Food and Agriculture Organization of the United Nations, FAO Food and Nutrition Paper No. 51. Rome, Italy: Food and Agriculture Organization;1991.
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