Nutritional intervention to reduce complications associated with high-output ostomies in adult patients: a narrative review
DOI:
https://doi.org/10.52611/confluencia.num2.2023.1047Keywords:
Ileostomy, Colostomy, Nutrition Therapy, Nutritional Status, Intestinal AbsorptionAbstract
Introduction: Ostomies are surgically created for patients with intestinal pathologies in order to protect an anastomosis and preserve remaining functions. Various disorders may occur in these patients, one of the most common being high output (bowel movements greater than 1.4 L) frequently in 24 hours or more. Objective: To determine the optimal nutritional management for the treatment of adult patients with high output ostomies. Methodology: A review of the literature related to high output ostomies in adult patients (>18 years) and the respective nutritional interventions was conducted, including primary studies with a quantitative approach and clinical management protocols published between 2018 and 2023 in English and Spanish. Results: The important points to address are the consistency of output and electrolyte losses due to dehydration. Discussion: The use of foods or supplements with a source of soluble fibre and the use of isotonic solutions with added nutrients is recommended.
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Pine J, Stevenson L, On J. Intestinal stomas. Surg Oxf [Internet]. 2020 [citado 28 de agosto de 2023];38(1):51-7. Disponible en: https://doi.org/10.1016/j.mpsur.2019.10.020
Boutté HJ, Poylin V. High ileostomy output: A practical review of pathophysiology, causes, and management. Semin Colon Rectal Surg [Internet]. 2023 [citado 28 de agosto de 2023];34(2):100955. Disponible en: https://doi.org/10.1016/j.scrs.2023.100955
Arenas Villafranca JJ, Abilés J, Moreno G, Tortajada Goitia B, Utrilla Navarro P, Gándara Adán N. Ostomías de alto débito: detección y abordaje. Nutr Hosp [Internet]. 2014 [citado 28 de agosto de 2023];30(6):1391-6. Disponible en: https://dx.doi.org/10.3305/nh.2014.30.6.7894
Rowe KM, Schiller LR. Ileostomy diarrhea: Pathophysiology and management. Proc Bayl Univ Med
Cent [Internet]. 2020 [citado 28 de agosto de 2023];33(2):218-26. Disponible en: https://doi.org/10.1080%2F08998280.2020.1712926
Takeda M, Takahashi H, Haraguchi N, Miyoshi N, Hata T, Yamamoto H, et al. Factors predictive of high-output ileostomy: a retrospective single-center comparative study. Surg Today [Internet]. 2019 [citado 28 de agosto de 2023];49(6):482-7. Disponible en: https://doi.org/10.1007%2Fs00595-018-1756-2
Vasilopoulos G, Makrigianni P, Polikandrioti M, Tsiampouris I, Karayiannis D, Margari N, et al. Pre- and Post-Operative Nutrition Assessment in Patients with Colon Cancer Undergoing Ileostomy. Int J Environ Res Public Health [Internet]. 2020 [citado 28 de agosto de 2023];17(17):6124. Disponible en:
https://doi.org/10.3390%2Fijerph17176124
Claessens I, Probert R, Tielemans C, Steen A, Nilsson C et al. The Ostomy Life Study: The everyday challenges faced by people living with a stoma in a snapshot. Gastrointestinal Nursing [Internet]. 2015 [citado 28 de agosto de 2023];13(5):18-25. Disponible en: https://doi.org/10.12968/gasn.2015.13.5.18
Hubbard G, Taylor C, Watson AJM, Munro J, Goodman W, Beeken RJ. A physical activity intervention to improve the quality of life of patients with a stoma: a feasibility study. Pilot Feasibility Stud [Internet]. 2020 [citado 28 de agosto de 2023];6(1):12. Disponible en: https://doi.org/10.1186/s40814-020-0560-0
Micho?ska I, Polak-Szczyby?o E, Sokal A, JarmakiewiczCzaja S, St?pie? AE, Dere? K. Nutritional Issues Faced by Patients with Intestinal Stoma: A Narrative Review. J Clin Med [Internet]. 2023 [citado 28 de agosto de 2023];12(2):510. Disponible en: https://doi.org/10.3390%2Fjcm12020510
Wang X, Cheng G, Tao R, Qu Z, Tang W, Deng Y, et al. Clinical characteristics and predictors of permanent stoma in rectal cancer patients underwent anterior resections: the value of preoperative prognostic nutritional index. Int J Clin Oncol [Internet]. 2020 [citado 28 de agosto de 2023];25(11):1960-8. Disponible en: https://doi.org/10.1007/s10147-020-01743-5
Santamaría MM, Villafranca JJA, Abilés J, Ruiz FR, Navarro PU, Goitia BT. Impact of a nutrition consultation on the rate of high output stoma-related readmission: an ambispective cohort study. Sci Rep [Internet]. 2021 [citado 28 de agosto de 2023];11:16620. Disponible en: https://doi.org/10.1038/s41598-021-96136-7
Nightingale JMD. How to manage a high-output stoma. Frontline Gastroenterol [Internet]. 2022 [citado 28 de agosto de 2023];13(2):140-51. Disponible en: https://doi.org/10.1136/flgastro-2018-101108
Ho CY, Majid HA, Jamhuri N, Ahmad AF, Selvarajoo TA. Lower ileostomy output among patients with postoperative colorectal cancer after being supplemented with partially hydrolyzed guar gum: Outcome of a pilot study. Nutrition [Internet]. 2022 [citado 28 de agosto de 2023];103-104:111758. Disponible en: https://doi.org/10.1016/j.nut.2022.111758
Rosli D, Shahar S, Manaf ZA, Lau HJ, Yusof NYM, Haron MR, et al. Randomized Controlled Trial on the Effect of Partially Hydrolyzed Guar Gum Supplementation on Diarrhea Frequency and Gut Microbiome Count Among Pelvic Radiation Patients. J Parenter Enter Nutr [Internet]. 2021 [citado 28 de agosto de 2023];45(2):277-86. Disponible en: https://doi.org/10.1002/jpen.1987
Fernández-Gálvez A, Rivera S, Durán Ventura M del C, de la Osa RMR. Nutritional and Educational Intervention to Recover a Healthy Eating Pattern Reducing Clinical Ileostomy-Related Complications. Nutrients [Internet]. 2022 [citado 28 de agosto de 2023];14(16):3431. Disponible en: https://doi.org/10.3390/nu14163431
Arnott SM, Zollinger B, Haviland S, Ng M, Obias V. A nutritional screening threshold for optimal outcomes after Hartmann’s reversal. Int J Colorectal Dis [Internet]. 2022 [citado 28 de agosto de 2023];37(9):2041-8. Disponible en: https://doi.org/10.1007/s00384-022-04236-1
Migdanis A, Koukoulis G, Mamaloudis I, Baloyiannis I, Migdanis I, Kanaki M, et al. Administration of an Oral Hydration Solution Prevents Electrolyte and Fluid Disturbances and Reduces Readmissions in Patients With a Diverting Ileostomy After Colorectal Surgery: A Prospective, Randomized, Controlled Trial. Dis Colon Rectum [Internet]. 2018 [citado 28 de agosto de
;61(7):840-6. Disponible en: https://doi.org/10.1097/dcr.0000000000001082
Munshi E, Bengtsson E, Blomberg K, Syk I, Buchwald P. Interventions to reduce dehydration related to defunctioning loop ileostomy after low anterior resection in rectal cancer: a prospective cohort study. ANZ J Surg [Internet]. 2020 [citado 28 de agosto de 2023];90(9):1627-31. Disponible en: https://doi.org/10.1111/ans.16258
Rud C, Pedersen AKN, Wilkens TL, Borre M, Andersen JR, Moeller HB, et al. An iso-osmolar oral supplement increases natriuresis and does not increase stomal output in patients with an ileostomy: A randomised, doubleblinded, active comparator, crossover intervention study. Clin Nutr [Internet]. 2019 [citado 28 de agosto de 2023];38(5):2079-86. Disponible en:
https://doi.org/10.1016/j.clnu.2018.10.014
Rutegård M, Häggström J, Back E, Holmgren K, Wixner J, Rutegård J, et al. Defunctioning loop ileostomy in anterior resection for rectal cancer and subsequent renal failure: nationwide population-based study. BJS Open [Internet]. 2023 [citado 28 de agosto de 2023];7(3):zrad010. Disponible en: https://doi.org/10.1093%2Fbjsopen%2Fzrad010
Fulham J. Providing dietary advice for the individual with a stoma. Br J Nurs Mark Allen Publ [Internet]. 2008 [citado
de agosto de 2023];17(2):S22-27. Disponible en: https://doi.org/10.12968/bjon.2008.17.Sup1.28146
Kaczmarek N, Kokot M, Makarewicz A, Glapa-Nowak A, Nowak J, Jamka M, et al. The therapeutic potential of short-chain fatty acids enemas in inflammatory bowel diseases: a systematic review. Farm Pol [Internet]. 2020 [citado 28 de agosto de 2023];76:297-304. Disponible en: http://dx.doi.org/10.32383/farmpol/125114
National Health Services. Dietary advice high output stoma [Internet]. UK: Berkshire Helthcare NHS Foundatios Trust. 2020 [citado 28 de agosto de 2023]. Disponible en: https://www.royalberkshire.nhs.uk/media/sfnj1ubq/dietary-advice-high-output-stoma_jan20.pdf
Niagara Health System. Nutritional Management of High Ostomy Outputs [Internet]. 2011 [citado 28 de agosto de
. Disponible en: https://www.niagarahealth.on.ca/files/OstmoyNutritional ManagementofHighOstomyOutputs2011.pdf
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