Pre- and Post-Operative Nutrition Assessment in Patients with Colon Cancer Undergoing Ileostomy

Abstract

Introduction: Patients undergoing ileostomy surgery often experience electrolyte disturbances and dehydration, especially during the first post-operative period. Recently, research has also begun on how the newly constructed ileostomy affects the patient’s nutritional status. Aim: The aim of the present pilot study was to assess the nutritional status of patients before and after the construction of the ileostomy as well as nutrition-related factors. Material and Method: This was a pilot study. The sample consisted of 13 adult patients diagnosed with colorectal or colon cancer who underwent scheduled ileostomy surgery. The evaluation tool used was “Original Full Mini Nutritional Assessment (MNA)”. Patients underwent nutritional assessment before the surgery (time 0), on the 7th post-operative day (time 1), and on the 20th post-operative day (time 2). The statistical significance level was set at p < 0.05. Results: All patients had a drop in MNA score on the 7th and 20th post-operative days. Factors associated with MNA were weight loss, mobility, body mass index (BMI), number of full meals consumed per day, portions of fruits and vegetables consumed per day, and mid-arm circumference, p < 0.05, respectively. Pre-operatively, 38.5%, of patients had severe weight loss (>3 kg), 23% moderate weight loss and 38.5% minimal weight loss. Pre-operatively, 92.3% of participants were able to move on their own and 69.2% on the 20th post-operatively day. Furthermore, BMI >23 kg/m2 had 84.6% of participants pre-operatively and 30.8% on the 20th post-operative day. In terms of portions of fruits and vegetables consumed per day, 30.8% of patients consumed at least 2 times, pre-operatively and no one (0%) on the 20th post-operative day. Moreover, pre-operatively all participants (100%) had arm circumference >22 cm while on the 20th post-operative day, only 38.5% of participants had arm circumference >22 cm. Conclusions: In the first 20 days after the construction of an ileostomy, the nutritional status of the patients is significantly affected. Decreased patient nutrition in both quantity and ingredients and reduced fluid intake appear to adversely affect the patient’s nutritional status.

“Living with a Stoma”: Exploring the Lived Experience of Patients with Permanent Colostomy

“…However, it is well known that when a patient is diagnosed with cancer, there is a spirit of overprotectiveness from the part of both the physician and the family [47]. According to Vasilopoulos et al [48], Greek patients with ileostomy experience reduced mobility and independence of living in post-surgery period that minimizes their ability to conduct selfcare and limits their social life as a result of physical impairment and emotional trauma [48].…”

Nutritional Issues Faced by Patients with Intestinal Stoma: A Narrative Review

“…Santamaria et al [ 13 ] used the SGA for the assessment of nutrition in a group of patients with ileostomy with High Output Stoma (HOS), which is a well-known and standardized tool. In addition, patients with colon cancer who underwent a scheduled ileostomy surgery, were diagnosed before and after with the MNA [ 14 ]. The last two questionnaires are based on similar questions, and are slightly longer, however, still fit on one page.…”

“…The last two questionnaires are based on similar questions, and are slightly longer, however, still fit on one page. This allows them to be carried out efficiently and repeated regularly during the patients’ stay in the hospital [ 13 , 14 , 15 ]. If a patient is qualified for a nutritional treatment, the first step is to perform an in-depth evaluation of the nutritional status of that patient.…”

Energy and Nutrient Intake in Ostomy Patients and Correlations With Anthropometric Variables: Results From a Reference Hospital in the State of Pernambuco, Brazil

“…Adequate food intake and meeting the individual nutritional needs of ostomy patients can prevent the nutrient deficits often found in this population. The main deficiencies are related to the loss of proteins, carbohydrates, fats, vitamins A, C, D, E, and B12, folic acid, zinc, magnesium, calcium, selenium, iron, and some electrolytes, such as sodium and potassium (6,1,2) .…”