Body composition in ileostomy patients with and without ileal resection.

Abstract

SUMMARY Body composition was measured in 24 patients who had previously undergone proctocolectomy and ileostomy. One group (control group) had undergone resection of only small amounts of terminal ileum (median 4 cm), the other group of patients (resected group) had undergone resection of greater lengths of small bowel (median 54 cm). These values of body composition were then compared with predicted values in normal subjects. Proctocolectomy and ileostomy without ileal resection did not significantly affect body weight, or the body contents of fat or water, but led to a reduction in total body nitrogen and total body potassium, suggesting a reduction in fat free mass. A modest resection of the terminal ileum undertaken during the course of proctocolectomy decreased body weight largely because of a reduction in body fat. None of the ileostomy patients was found to be dehydrated.

Body composition in patients with an ileostomy and inflammatory bowel disease: validation of bio-electric impedance spectroscopy (BIS)

“…The number of subjects was similar to most previous studies on stable ileostomates (Cooper et al, 1986;Hill et al, 1975;Nilsson et al, 1982).…”

“…Ileostomy subjects have been investigated for dehydration without having recorded any significant differences (Cooper et al, 1986;Nilsson et al, 1982). Although the number of patients under study is small, the previous conclusion that ileostomy subjects have a normal body composition and the present observations on the validity of BIS make it reasonable to suggest that BIS can be used in these patients, at least under assumed normal hydration.…”

“…Moreover, recrudescence of intestinal inflammation, as in Crohn's disease, may cause chronic increase of fluid loss through the stoma. Although several studies have shown that subjects with an ileostomy and no inflammatory activity have a normal water content according to dilution and current techniques (Christie et al, 1990;Cooper et al, 1986;Nilsson et al, 1982), the increase in water turnover constitutes a risk of dehydration in case the ileostomy discharge is not compensated for.…”

“…BIS values consistently fell between values from dilution methods and DXA. Ileostomy subjects are included in a few previous reports (Christie et al, 1990;Cooper et al, 1986;Nilsson et al, 1982), but have not attracted much interest before. The IBD-population raises specific problems in the analysis of body composition: an increased susceptibility to dehydration was mentioned above.…”

Challenges of Managing Emergency Ileostomy: Nutrition—A Neglected Aspect

“…In addition to this, these patients often have an inappropriate food intake and are frequently in negative energy balance leading to malnutrition, impaired immunity, and deranged bodily functions [3]. Even a modest resection of the terminal ileum undertaken during the course of proctocolectomy decreased body weight largely because of a reduction in body fat [4]. It is important for healthcare professionals involved in the care of patients with an ileostomy to appreciate that stoma surgery changes the body's usual processes of nutritional absorption and excretion, so that informed support and advice on diet can be provided [5].…”