Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-26T18:57:46.933Z Has data issue: false hasContentIssue false
  • English
  • Français

Diet and health of people with an ileostomy

2. Ileostomy function and nutritional state

Published online by Cambridge University Press:  09 March 2007

N. I. McNeil ,
Sheila Bingham ,
T. J. Cole ,
A. M. Grant  and
J. H. Cummings
N. I. McNeil
Affiliation:
Dunn Clinical Nutrition Centre, Old Addenbrooke's Hospital, Trumpington Street, Cambridge, CB2 1QE and Department of Clinical Biochemistry, New Addenbrooke's Hospital, Cambridge, CB2 2QQ
Sheila Bingham
Affiliation:
Dunn Clinical Nutrition Centre, Old Addenbrooke's Hospital, Trumpington Street, Cambridge, CB2 1QE and Department of Clinical Biochemistry, New Addenbrooke's Hospital, Cambridge, CB2 2QQ
T. J. Cole
Affiliation:
Dunn Clinical Nutrition Centre, Old Addenbrooke's Hospital, Trumpington Street, Cambridge, CB2 1QE and Department of Clinical Biochemistry, New Addenbrooke's Hospital, Cambridge, CB2 2QQ
A. M. Grant
Affiliation:
Dunn Clinical Nutrition Centre, Old Addenbrooke's Hospital, Trumpington Street, Cambridge, CB2 1QE and Department of Clinical Biochemistry, New Addenbrooke's Hospital, Cambridge, CB2 2QQ
J. H. Cummings
Affiliation:
Dunn Clinical Nutrition Centre, Old Addenbrooke's Hospital, Trumpington Street, Cambridge, CB2 1QE and Department of Clinical Biochemistry, New Addenbrooke's Hospital, Cambridge, CB2 2QQ
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

1. Most subjects who have their large intestine removed and an ileostomy formed lead a healthy life after operation, although they are prone to a variety of metabolic problems. In order to determine the factors likely to lead to these metabolic disturbances a detailed assessment of ileostomy output and composition and of dietary intake in relation to nutritional and metabolic status has been made in a group of ileostomy patients living at home.

2. Thirty-six volunteers with established ileostomies (twenty-six ulcerative colitis (UC) patients and ten, Crohn's colitis (CC) patients) made a 24 h collection of urine and ileostomy effluent and kept a 7 d record of dietary intake and the frequency with which they emptied their ileostomy bag. Blood was collected for haematological and biochemical indices of nutritional status and height, weight and skinfold thickness were measured.

3. Effluent output for the whole group was 760±322 g/day (range 273–1612) and was very closely related to effluent sodium output (R 0·98). Stepwise multiple regression analysis of dietary and other variables identified the amount of ileum resected as the main determinant of both effluent output and effluent sodium. The CC group had significantly greater effluent output (1084±340 g/d) compared with the UC patients (635±215g/d) (P < 0·001); and excreted significantly more nitrogen, carbohydrate and sodium than the UC group.

4. The CC patients particularly showed evidence of salt depletion. The mean (±SD) 24 h urine Na loss for CC patients was 31±30 mmol and for UC patients 67±34 mmol (P < 0·01) with five of the ten CC patients v. four of the twenty-six patients with UC having raised urinary or plasma aldosterone levels.

5. All subjects had normal haematological and biochemical indices of nutritional status in the blood. Height and percentage body fat were also within the normal range when compared with a control population matched for age, sex and occupation, but patients with an ileostomy weighed on average 4·1 kg less than the controls.

6. These studies show that patients with an ileostomy come within the range of the normal population for most nutritional indices although are at increased risk of salt depletion. Effluent volume, which is probably the determining factor in most metabolic complications of ileostomy, is related more to the extent of the small bowel resection than to diet.

Type
Papers of direct reference to Clinical and Human Nutrition
Information
British Journal of Nutrition , Volume 47 , Issue 3 , May 1982 , pp. 407 - 415
Copyright
Copyright © The Nutrition Society 1982

References

Allan, R., Steinberg, D. M., Dixon, K. & Cooke, W. T. (1975). Gut 16, 201.CrossRefGoogle Scholar
Anderson, I. H., Levine, A. S. and Levitt, M. D. (1981). New Eng. J. Med. 304, 891.CrossRefGoogle Scholar
Bambach, C. P., Robertson, W. G., Peacock, M. & Hill, G. L. (1981). Gut 22, 257.CrossRefGoogle Scholar
Bates, C. J. (1977). Clin. Sci. 52, 535.CrossRefGoogle Scholar
Beahrs, O. H. (1971). Dis. Colon Rectum 14, 460.CrossRefGoogle Scholar
Bingham, S., Cummings, J. H. & McNeil, N. I. (1982). Br. J. Nutr. 47, 399.CrossRefGoogle Scholar
Bond, J. H., Currier, B. E., Buchwald, H. & Levitt, M. D. (1980). Gastroenterology 78, 444.CrossRefGoogle Scholar
Clarke, A. M., Chirnside, A., Hill, G. L., Pope, G. & Stewart, M. K. (1967). Lancet ii, 740.CrossRefGoogle Scholar
Cooke, W. T., Mallas, E., Prior, P. & Allan, R. N. (1980). Q. J. Med. 49, 363.Google Scholar
Crawford, N. & Brooke, B. N. (1957). Lancet i, 864.CrossRefGoogle Scholar
Cummings, J. H., Hill, M. J., Jenkins, D. J. A., Pearson, J. R. & Wiggins, H. S. (1976). Am. J. clin. Nutr. 29, 1468.CrossRefGoogle Scholar
Cummings, J. H., James, W. P. T. & Wiggins, H. S. (1973). Lancet i, 344.CrossRefGoogle Scholar
Cummins, A. J. (1954). Am. J. Med. 16, 237.CrossRefGoogle Scholar
Department of Health and Social Security & Medical Research Council (1976). Research on obesity. London: H.M. Stationery Office.Google Scholar
Deren, J. J., Porush, J. G., Levitt, M. F. & Khilnani, M. T. (1962). Ann. int. Med. 56, 843.CrossRefGoogle Scholar
Durnin, J. V. G. A. & Womersley, J. (1974). Br. J. Nutr. 32, 77.CrossRefGoogle Scholar
Edmonds, C. J. (1981). Clin. Sci. 61, 257.CrossRefGoogle Scholar
Edmonds, C. J. & Godfrey, R. C. (1970). Gut, 11, 330.CrossRefGoogle Scholar
Frazer, A. C., Hood, C., Davies, A. G., Carter, P. A., Montgomery, R. D., Schneider, R. & Goodhart, J. (1966). Lancet i, 503.CrossRefGoogle Scholar
Gallagher, N. D., Harrison, D. D. & Skyring, A. P. (1962). Gut 3, 219.CrossRefGoogle Scholar
Gitelman, H. J. (1967). Analyt. Biochem. 18, 520.CrossRefGoogle Scholar
Gorbach, S. L., Nahas, L., Weinstein, L., Levitan, R. & Patterson, J. F. (1967). Gastroenterology 53, 874.CrossRefGoogle Scholar
Hill, G. L. (1976). Ileostomy: Surgery, Physiology and Management. New York: Grune and Stratton.CrossRefGoogle Scholar
Hill, G. L., Goligher, J. C., Smith, A. H. & Mair, W. S. J. (1975). Br. J. Surg. 62, 524.CrossRefGoogle Scholar
Hill, G. L., Mair, W. S. J., Edwards, J. P., Morgan, D. B. & Goligher, J. C. (1975). Gastroenterology 68, 676.CrossRefGoogle Scholar
Hill, G. L., Mair, W. S. J. & Goligher, J. C. (1974). Gut 15, 982.CrossRefGoogle Scholar
Hill, G. L., Mair, W. S. J. & Goligher, J. C. (1975). Br. J. Surg. 62, 720.CrossRefGoogle Scholar
Hill, G. L. & Goligher, J. C. (1975). Gut 16, 932.CrossRefGoogle Scholar
Hill, G. L., Millward, S. F., King, R. F. G. J. & Smith, R. C. (1979). Br. med. J. ii, 831.CrossRefGoogle Scholar
Hudson, G. J., John, P. M. V., Bailey, B. S. & Southgate, D. A. T. (1976). J. Sci. Fd Agric. 27, 681.CrossRefGoogle Scholar
Hulton, L., Holm, C. & Kewenter, J. (1971). Acta Chir. scand. 137, 689.Google Scholar
Isaacs, P. E. T., Horth, C. E. & Turnberg, L. A. (1976). Gastroenterology 70, 52.CrossRefGoogle Scholar
Jones, M. R., Gregory, D., Evans, K. T. & Rhodes, J. (1976). Clin. Radiol. 27, 561.CrossRefGoogle Scholar
Kanaghinis, T., Lubran, M. & Coghill, N. F. (1963). Gut 4, 322.CrossRefGoogle Scholar
Kennedy, H. J., Truelove, S. C. & Warner, G. T. (1981). Clin. Sci. 61, 14P.CrossRefGoogle Scholar
Kramer, P., Kearney, M. M. & Ingelfinger, F. J. (1962). Gastroenterology 42, 535.CrossRefGoogle Scholar
Kramer, P. & Levitan, R. (1972). Gastoenterology 62, 235.CrossRefGoogle Scholar
Levine, S. M., Gelfand, M., Hersh, T., Wyshak, G., Spiro, H. M. & Floch, M. H. (1970). Am. J. dig. Dis. 15, 523.CrossRefGoogle Scholar
Lockhart-Mummery, H. E. & Morson, B. C. (1960). Gut 1, 87.CrossRefGoogle Scholar
McNeil, N. I., Cummings, J. H. & James, W. P. T. (1978). Gut 19, 819.CrossRefGoogle Scholar
Maratka, Z. & Nedbal, J. (1964). Gut 5, 214.CrossRefGoogle Scholar
Nuguid, T. P., Bacon, H. E. & Boutwell, J. (1961). Sug. Gynec. Obstet. 113, 733.Google Scholar
Pelletier, O. (1968). J. Lab. clin. Med. 72, 674.Google Scholar
Ritchie, J. K. (1971). Gut 12, 528.CrossRefGoogle Scholar
Salem, S. N. & Truelove, S. C. (1965). Br. med. J. i, 827.CrossRefGoogle Scholar
Sammons, H. G. (1961). Biochem. J. 80, 30P.Google Scholar
Smiddy, F. G., Gregory, S. D., Smith, I. B. & Goligher, J. C. (1960). Lancet i, 14.CrossRefGoogle Scholar
Stephen, A. M. & Cummings, J. H. (1980). J. med. Microbiol. 13, 45.CrossRefGoogle Scholar
Technicon Instrument Co. Ltd. (1964). Technicon Symposium in Frankfurt. Basingstoke, Hants:Technicon Instrument Co. Ltd.Google Scholar
Thomson, T. J., Runcie, J. & Khan, A. (1970). Gut 11, 482.CrossRefGoogle Scholar
Turnberg, L. A., Morris, A. I., Hawker, P. C., Herman, K. J., Shields, R. A. & Horth, C. E. (1978). Gut 19, 563.CrossRefGoogle Scholar
Tytgat, G. N., Huibregtse, K., Dagevos, J. & Van Den Ende, A. (1977). Am. J. dig. Dis. 22, 669.CrossRefGoogle Scholar
Usher, C. D., Green, C. J. & Smith, C. A. (1973). J. Fd Technol. 8, 429.CrossRefGoogle Scholar