Lower ileostomy output among patients with postoperative colorectal cancer after being supplemented with partially hydrolyzed guar gum: Outcome of a pilot study

Ho, Chiou Yi; Majid, Hazreen Abdul; Jamhuri, Norshariza; Ahmad, Atiki Falparado; Selvarajoo, Tharmasilen

doi:10.1016/j.nut.2022.111758

Cited by 5 publications

(7 citation statements)

References 29 publications

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“…Thereafter, the partially hydrolysed guar gum fibre was added to the diet and tested in the following 16 patients with an ileostomy. The ileostomy output was significantly lower in the intervention group, whereby a significant inverse association was seen between the fibre intake and the ileostomy output 25 …”

Section: Discussionmentioning

confidence: 84%

“…The ileostomy output was significantly lower in the intervention group, whereby a significant inverse association was seen between the fibre intake and the ileostomy output. 25 Whereas such interventions can be used for large children and adolescents (even though therapy compliance is nevertheless highly challenging), the opposite is true for infants and small children due to the lack of normal oral intake. The 2023 ESPGHAN Committee on Nutrition have made recommendations for oral intake strategies in infants with a short bowel syndrome during the postoperative phase.…”

Section: Conservative Managementmentioning

confidence: 99%

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Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Stoop,

van Bodegraven,

ten Haaft

et al. 2023

J. pediatr. gastroenterol. nutr.

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Objectives/BackgroundHigh‐output stoma is one of the most common major morbidities in young children with an enterostomy that could lead to intestinal failure. Management of high‐output enterostomy in children is mostly based on personal experience. This systematic review aims to clarify the evidence‐based therapeutic approach of high‐output enterostomy in children.MethodsA systematic review was performed using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published until March 20, 2023, following the 2020 Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. The study population comprised children (i.e., age <18 years) with high‐output enterostomy (i.e., jejuno‐, ileo‐, and/or colostomy), regardless of underlying aetiology. Interventions comprised any (non)pharmacological and/or surgical treatment. Interventions were compared with each other, placebos, and/or no interventions. Primary outcome was reduction of enterostomy output. Secondary outcomes were morbidity, mortality, quality of life, associated healthcare costs, and adverse events.ResultsThe literature search identified 4278 original articles of which 366 were screened on full text, revealing that none of the articles met the inclusion criteria.ConclusionThis first systematic review on management of high‐output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking. There is an urgent need for evidence on conservative treatment strategies including fluid restrictions, dietary advices, oral rehydration solution, chyme re‐infusion, and pharmacological and surgical treatments of high‐output enterostomy in children, aiming to reduce the risk for short‐ and long‐term complications. Till more evidence is available, a systematic and multidisciplinary step‐up approach is needed. Therefore, a therapeutic work‐up is proposed that could guide the care.

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Section: Discussionmentioning

confidence: 84%

Section: Conservative Managementmentioning

confidence: 99%

Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Stoop,

van Bodegraven,

ten Haaft

et al. 2023

J. pediatr. gastroenterol. nutr.

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“…On the other hand, soluble fibres have been reported to increase stool consistency and intestinal transit time 55 . Partially hydrolysed guar gum decreased ostomy output and increased stool consistency in 29 adult patients with an ileostomy 56 . The use of 2–6 g of guar gum in each meal has also been reported in paediatric patients with short bowel syndrome.…”

Section: Resultsmentioning

confidence: 99%

“…55 Partially hydrolysed guar gum decreased ostomy output and increased stool consistency in 29 adult patients with an ileostomy. 56 The use of 2-6 g of guar gum…”

Section: Toddlers and Older Childrenmentioning

confidence: 99%

Nutritional management of high‐output ileostomies in paediatric patients is vital and more evidence‐based guidelines are needed

Awouters,

Vanuytsel,

Huysentruyt

et al. 2024

Acta Paediatrica

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AimPaediatric patients with high‐output ileostomies (HOI) face an elevated risk of complications. This study aimed to comprehensively review the existing literature and offer nutritional management recommendations for paediatric patients with an HOI.MethodsPubMed and Embase were searched for relevant English or French language papers up to 31 June 2022. The emphasis was placed on studies involving paediatric ileostomy patients, but insights were obtained from adult literature and other intestinal failure pathologies when these were lacking.ResultsWe identified 16 papers that addressed nutritional issues in paediatric ileostomy patients. Currently, no evidence supports a safe paediatric HOI threshold exceeding 20 mL/kg/day on two consecutive days. Paediatric HOI patients were at risk of dehydration, electrolyte disturbances, micronutrient deficiencies and growth failure. The primary dietary choice for neonates is bolus feeding with breastmilk. In older children, an enteral fluid restriction should be installed favouring isotonic or slightly hypotonic glucose‐electrolyte solutions. A diet that is high in calories, complex carbohydrates and proteins, low in insoluble fibre and simple carbohydrates, and moderate in fat is recommended.ConclusionAdequate nutritional management is crucial to prevent complications in children with an HOI. Further research is needed to establish more evidence‐based guidelines.

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“…Since the use of prebiotic fibers in reducing diarrhea is still inconclusive (84), leading to soluble PHGC fiber as a possible intervention strategy to minimize stoma evacuation. Several local cases reported from Malaysia have shown that PHGC fiber helps to reduce high stoma output in colorectal cancer patients after ileostomy (85), as well as chemotherapy-induced high ileostomy output. This is an important guideline for patients with ovarian cancer who require chemotherapy in conjunction with surgery.…”

Section: Choice Of Stoma Solutionmentioning

confidence: 99%

Application and evaluation of transitory protective stoma in ovarian cancer surgery

Fan

et al. 2023

Front. Oncol.

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Ovarian cancer is the most fatal of all female reproductive cancers. The fatality rate of OC is the highest among gynecological malignant tumors, and cytoreductive surgery is a common surgical procedure for patients with advanced ovarian cancer. To achieve satisfactory tumor reduction, intraoperative bowel surgery is often involved. Intestinal anastomosis is the traditional way to restore intestinal continuity, but the higher rate of postoperative complications still cannot be ignored. Transitory protective stoma can reduce the severity of postoperative complications and traumatic stress reaction and provide the opportunity for conservative treatment. But there are also many problems, such as stoma-related complications and the impact on social psychology. Therefore, it is essential to select appropriate patients according to the indications for the transitory protective stoma, and a customized postoperative care plan is needed specifically for the stoma population.

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Lower ileostomy output among patients with postoperative colorectal cancer after being supplemented with partially hydrolyzed guar gum: Outcome of a pilot study

Cited by 5 publications

References 29 publications

Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Nutritional management of high‐output ileostomies in paediatric patients is vital and more evidence‐based guidelines are needed

Application and evaluation of transitory protective stoma in ovarian cancer surgery

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