Challenges of Managing Emergency Ileostomy : Nutrition—A Neglected Aspect

Abstract EN

Objective.

The present study was carried out with an aim to study the nutritional status of patients undergoing emergency ileostomy using simple bedside tools in a developing country.

Methods.

Nutritional assessment (anthropometry, biochemical, immunological, and dietary) was done within 24–36 hours of admission and 6 weeks postoperatively.

Primary endpoint was the study of the nutritional status of the patients with ileostomy.

Results.

N=58, 47 males with mean age 32 years.

Postoperatively 50 (86.2%) patients experienced some complications including those related to ileostomy.

Malnutrition varied from 7 (12.1%) using BMI to 54 (93.1%) by triceps skinfold thickness.

At 6 weeks, despite adequate nutritional intake, there was a significant decrease in almost all nutritional parameters except serum albumin which was normal in most patients.

Factors contributing to weight loss in 41 (70.7%) patients were decreased length of proximal bowel left (P=0.001), increased ileostomy output (P=0.001), delayed surgery (P=0.004), and increased disease severity score (P=0.005).

Conclusion.

Majority of patients undergoing emergency ileostomy were malnourished and had significant nutritional depletion despite adequate nutritional support.

Serial assessment helps to assess nutritional recovery in these patients.