Dietary advice and management for people with an ileostomy

Abstract

Background: Ileostomy formation is a common surgical procedure. Complications include high output and obstruction for which dietary management is common but not clearly defined.

Aim: To explore dietary advice and modifications for ileostomy management through investigation of the current evidence and experiences of people with an ileostomy, and healthcare professionals (HCPs).

Methods: 1) A systematic scoping review of the evidence for dietary management in people with an ileostomy, following JBI methodology. Experimental, observational, and qualitative studies were included, as well as published expert opinion from the last decade. 2) An online survey asking adults with an ileostomy about dietary advice they received and would have preferred to receive. 3) A qualitative study involving in-depth interviews with hospital-based HCPs; analysed thematically using the framework method.

Results: The review found an abundance of literature, particularly expert opinion, on dietary management for people with an ileostomy. However, this literature was highly heterogenous in terms of dietary strategies and outcomes reported. Of 291 survey respondents, 90 did not receive dietary advice; however, 82 (91%) of these would have liked advice. >1/3 of respondents experienced anxiety, confusion, and frustration relating to their diet. Stoma nurses were the most common source of dietary advice. Qualitative findings revealed differences in understanding, priorities and framing of dietary advice between professions which may contribute to conflicting information. Inter-disciplinary working increased HCP confidence in, and consistency of, dietary advice to patients with an ileostomy but varied between hospitals.

Conclusion: People with an ileostomy need better dietary advice. This could reduce anxiety and physical complications, improving quality of life and reducing burden on the NHS. To achieve this, high quality research evaluating dietary management and provision of dietary advice for people with an ileostomy is a priority to inform best practice. Findings from this thesis will inform future development of relevant and realistic dietary interventions.

Date of Award	25 Jan 2022
Original language	English
Awarding Institution	University of Bristol
Supervisor	Charlotte Atkinson (Supervisor), Clare Y England (Supervisor) & Aidan J Searle (Supervisor)