Changes in body mass index and stoma related problems in the elderly

Abstract

Objectives Weight gain can cause retraction of an intestinal stoma, possibly resulting in difficulty with wafer and pouch fit, daily care challenges, and discomfort. This cross-sectional study examined the association between body mass index (BMI) and ostomy-related problems among long-term (>5 years post-diagnosis) colorectal cancer (CRC) survivors. Materials and Methods CRC survivors from three Kaiser Permanente Regions completed a mailed survey. The response rate for those with an ostomy was 53% (283/529). Questions included stoma-related problems and time to conduct daily ostomy care. Poisson regression evaluated associations between report of problems and change in BMI. Our analysis sample included 235 survivors. Results Sample was 76% ≥65 years of age. Since their surgeries, BMI remained stable in 44% (ST), decreased in 20% (DE), and increased in 35% (IN) of survivors. Compared to ST, male IN (RR 2.15 [1.09–4.25]) and female DE (RR 5.06 [1.26–25.0]) were more likely to spend more than 30 minutes per day on stoma care. IN (vs. ST) were more likely to report interference with clothing (RR 1.51 [1.06–2.17]) and other stoma-related problems (RR 2.32 [1.30–4.14]). Survivors who were obese at time of survey were more likely to report interference with clothing (RR 1.88 [1.38–2.56]) and other stoma-related problems (RR 1.68 [1.07–2.65]). Conclusion A change in BMI is associated with ostomy-related problems among long-term CRC survivors. Equipment and care practices may need to be adapted for changes in abdominal shape. Health care providers should caution that a significant increase or decrease in BMI may cause ostomy-related problems.

A chronic care ostomy self‐management program for cancer survivors

“…There may be gaps of knowledge that may arise from lack of training or forgetfulness of specific recommendations. As long‐term survivors age, they may have problems related to vision, arthritis, or changes in body habitus . Social factors may change, such as the death of a spouse, a child moving away, or retirement .…”

Ongoing ostomy self-care challenges of long-term rectal cancer survivors

“…Participants also reported their height, current weight, and their approximate weight at the time of surgery. From this information we calculated three BMI measures: BMI at time of survey (continuous), BMI increase from surgery to survey of ≥1.5 (yes / no), and BMI decrease from surgery to survey of ≥1.5 (yes / no) [22].…”

“…Physical, personal, and environmental factors influence ostomy self-care. Physical factors include the ostomy shape and location [21], having an ileostomy versus a colostomy, having additional abdominal surgeries, having a high BMI, or having had a major change in BMI since surgery [22]. Health conditions unrelated to the ostomy or body habitus, such as an individual’s current physical health or comorbidity burden, may also impact ostomy self-care [23].…”

Perfil De Pessoas Estomizadas De Uma Região De Saúde Mineira

“…Os profissionais de saúde devem entender as mudanças relacionadas ao envelhecimento e como elas podem afetar o autocuidado das pessoas estomizadas. Deve ser considerado, ainda, que os homens parecem ter mais dificuldade com ajustamento emocional após a cirurgia, quando comparados com as mulheres mais idosas com ostomias (12) .…”