Colorectal Resection, Ileostomy
Conditions
Keywords
ileostomy, colorectal resection, dehydration, nutritional status
Brief summary
One of the main reasons for hospital readmission in ileostomy patients is fluid and electrolyte abnormalities. Prospective observational studies have suggested an occurrence rate of around 20%. Due to colonic exclusion ileostomy patients lose large amounts of sodium and fluid through their stoma effluent. In addition studies have shown that ileostomy construction is a risk factor for renal impairment, occurring secondary to dehydration. Encouraging patients to increase total fluid intake seems to be a common mistake in clinical practice as this can dilute sodium levels even more, causing greater sodium depletion. In terms of addressing the problem a few small studies have used isotonic drinks of various compositions showing increased electrolyte absorption. Other dietary complications sometimes include hypomagnesaemia and decreased absorption of B-12 and folic acid, however due to the integrity of the small intestine other nutrient malabsorption is unlikely to occur. As far as body composition is concerned obesity has been shown to be a risk factor for peri- and postoperative complications in colorectal surgery (e.g. peristomal dermatitis, stoma stenosis and prolapse). A prospective trial examining measures that can prevent readmission for dehydration and other nutritional considerations related to this group of patients is definitely required. Hypothesis: The administration of an oral rehydration solution will allow a significant decrease in dehydration and electrolyte abnormality rates in patients with a temporary ileostomy.
Interventions
DIETARY_SUPPLEMENTOral Ηydration Solution
Oral rehydration solution containing: sodium chloride, sodium citrate, glucose, magnesium citrate, food additives and water.
OTHERAdvise on calculated oral fluid requirements
OTHERNo nutritional advice will be given
Sponsors
University of Thessaly
Larissa University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male of female patients of more than 18 years of age * Patients who have undergone a rectosigmoidectomy procedure resulting or not in an ileostomy formation
Exclusion criteria
* Short Bowel Syndrome * Diabetic ketoacidosis * Chronic Renal failure * Hepatic/Cardiac failure * Diabetes insipidus * Diuretic Medication * Corticosteroid Medication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Serum electrolyte levels | up to 20-40 days postoperatively | sodium (mmol/l) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Physical findings of dehydration | 20 days postoperatively, 40 days postoperatively | thirst, dizziness, lethargy, oliguria, dense urine |
| Biochemical markers reflecting dehydration and renal function | 20 days postoperativey, 40 days postoperatively | Urea (mg/dl) |
| Anthropometric characteristics | baseline, 40 days postoperatively | weight (kg) |
| Nutritional Intake | baseline, at 20 days and 40 days postoperatively | Energy intake assessed through 24hour recalls and analyzed via nutrition analysis software |
| Stoma output (ml/L) | baseline, at 20 days and 40 days postoperatively | — |
Countries
Greece
Outcome results
None listed