Anthropometric and Dietetic Evaluation of People With Ileostomies

Abstract

BACKGROUND: The maintenance of nutrition for the person with ileostomy is a major challenge despite to the proper management of stoma eliminations. OBJECTIVE: This study aimed to evaluate the nutritional status of people with ileostomy. METHOD: This is a cross-sectional study carried out on a population of 17 people with ileostomy enrolled in the Service of Attention to the Health of the Person with Stoma of level II, referring to a health region in Minas Gerais. The anthropometric evaluation consisted of the collection of weight, height, and calculation of body mass index. A 24-hour food recall and the nutritional assessment method Global Subjective Assessment were also evaluated. The data were analyzed by the Dietbox software, where the ingested nutrients were estimated, and by the Statistical Package for the Social Sciences version 22.0. RESULTS: There was a predominance of a population composed of people over 50 years old, female, married and single, with family income between two and three minimum wages, incomplete elementary school and that did not exercise paid activity. The cancer was given as the main diagnosis that originated the stoma and had a surgery time of less than two years. Regarding nutritional status, most of the interviewees presented adequate body mass index, but more than half reported significant weight loss after the ileostomy. The predominant nutritional diagnosis provided by the General Subjective Assessment was “suspected malnutrition/moderate malnutrition”. On the other hand, the contribution of energy, carbohydrates, lipids, sodium, potassium, magnesium and vitamin B12 was considered insufficient in almost all the participants. CONCLUSION: Therefore, it is suggested the periodic evaluation of the nutritional status of this population. Thus, it is expected that preventive, therapeutic and maintenance dietary diagnosis and planning may contribute to the nutritional status of the person with the ileostomy.

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

“…Moraes et al [ 12 ] showed weight loss in more than half of patients after ileostomy who in the majority were above 50 years old, female, married and of incomplete elementary school. A relevant study conducted by Kim et al [ 21 ] showed severe weight loss and BMI reduction, post-operatively among 72.7% ( n = 50) of patients who underwent a colostomy or prophylactic ileostomy.…”

“…Early HOS (within 3 weeks of stoma formation) occurred in 75 (16%) of ileostomies/jejunostomies [ 23 ]. However, in less than two years after surgery, patients present adequate BMI [ 12 ].…”

“…Interestingly, patients with an ileostomy tend to decrease total intake and restrict consumption of some foods due to repercussions on the volume and appearance of feces and other issues associated with aesthetics and well-being. Avoidance of certain foods may in turn increase the risk for nutritional deficiencies [ 12 ]. Notably, quality and quantity of food is crucial for ileostomy patients since reduction in protein intake may affect tissue repair after surgical construction of a stoma.…”

“…In more detail, the ileum is responsible for the absorption of lipids, carbohydrates, proteins and vitamin B12 [ 9 ]. Patients being typically deprived of their terminal ileum are at higher risk for dehydration, impaired nutritional status, electrolyte imbalances, deficiencies in B-12, iron, magnesium, fat, and folic acid [ 11 , 12 ]. Therefore, it is clinically meaningful to provide nutrition support (oral, enteral or parenteral), water and electrolytes in order to prevent malnutrition [ 9 ] along with proper dietary requirements [ 11 ].…”

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

“…The word ostomy has a Greek origin (stóma) and is a temporary or definitive opening connecting the bowels to the external environment. Intestinal ostomies are performed for the clinical control of pathological conditions that interfere with normal intestinal transit, such as neoplasms, trauma, congenital abnormalities, inflammatory diseases, and obstructions (1,2) . There are two types of intestinal ostomies (ileostomy and colostomy), which respectively consist of an anastomosis of the ileal or colic segment to the anterior abdominal wall (1) .…”