Department of Dietetics and Food Services, Institut Kanser Negara, Ministry of Health, Putrajaya, Malaysia.
Centre for Population Health, Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.
Nutrition. 2022 Nov-Dec;103-104:111758. doi: 10.1016/j.nut.2022.111758. Epub 2022 Jun 1.
High stoma output is a significant complication after bowel surgery that causes dehydration, resulting in acute kidney injury, electrolyte imbalances, unintentional weight loss, and malnutrition. This study evaluates the postoperative ileostomy output among patients with colorectal cancer after being supplemented with partially hydrolyzed guar gum.
This cross-sectional study collected sociodemographic and clinical characteristics, stoma output, and dietary intake upon discharge, hospitalization, and readmission within 30 d of discharge.
A total of 29 participants were recruited, with 72.4% having moderate malnutrition risk. Patients who received partially hydrolyzed guar gum (PHGG) fiber reported lower stoma output with firmer output consistency than patients who received standard care (SC) (P < 0.05 and P < 0.01). Patients who received PHGG achieved higher energy, protein, and soluble fiber intake than did the SC group (P < 0.01) upon discharge. There was a significant inverse association between soluble fiber (PHGG fiber + dietary soluble fiber) intake and ileostomy output (r, -0.494; P = 0.006).
Partially hydrolyzed guar gum fiber acts as an agent to hold water, reduce the speed of gastrointestinal tract transit, increase effluent viscosity, and potentially decrease water losses. Supplementation with PHGG fiber appeared to minimize ileostomy output and improve clinical outcomes among postoperative ileostomy patients. This needs to be evaluated further with a randomized controlled trial to confirm this preliminary finding.
肠造口术后高输出量是一种严重的并发症,可导致脱水,进而引起急性肾损伤、电解质失衡、非故意体重减轻和营养不良。本研究评估了补充部分水解瓜尔胶后结直肠癌患者术后回肠造口输出量。
这是一项横断面研究,收集了社会人口学和临床特征、造口输出量以及出院时、住院期间和出院后 30 天内的饮食摄入量。
共招募了 29 名参与者,其中 72.4%有中度营养不良风险。与接受标准护理(SC)的患者相比,接受部分水解瓜尔胶(PHGG)纤维的患者报告的造口输出量更低,输出物稠度更硬(P < 0.05 和 P < 0.01)。出院时,接受 PHGG 的患者摄入的能量、蛋白质和可溶性纤维均高于 SC 组(P < 0.01)。可溶性纤维(PHGG 纤维+饮食可溶性纤维)摄入量与回肠造口输出量呈显著负相关(r,-0.494;P=0.006)。
部分水解瓜尔胶纤维作为一种持水剂,可减缓胃肠道转运速度,增加流出物粘性,从而可能减少水分流失。补充 PHGG 纤维似乎可最大程度地减少术后回肠造口患者的造口输出量并改善临床结局。这需要进一步通过随机对照试验来证实这一初步发现。