Changes in body mass index and stoma related problems in the elderly.
OBJECTIVE
Weight gain can cause retraction of an intestinal stoma, possibly resulting in difficulty with wafer and pouch fit, daily care challenges, and discomfort. This cross-sectional study examined the association between body mass index (BMI) and ostomy-related problems among long-term (>5years post-diagnosis) colorectal cancer (CRC) survivors.


METHODS
CRC survivors from three Kaiser Permanente Regions completed a mailed survey. The response rate for those with an ostomy was 53% (283/529). Questions included stoma-related problems, and time to conduct daily ostomy care. Poisson regression evaluated associations between report of problems and change in BMI. Our analysis sample included 235 survivors.


RESULTS
Sample was 76% ≥65years of age. Since their surgeries, BMI remained stable (ST) in 44% (103), decreased (DE) in 20% (48), and increased (IN) in 36% (84). Compared to ST, male IN (RR 2.15 [1.09-4.25]) and female DE (RR 5.06 [1.26-25.0]) were more likely to spend more than 30min per day on stoma care. IN (vs. ST) were more likely to report interference with clothing (RR 1.51 [1.06-2.17]) and other stoma-related problems (RR 2.32 [1.30-4.14]). Survivors who were obese at time of survey were more likely to report interference with clothing (RR 1.88 [1.38-2.56]) and other stoma-related problems (RR 1.68 [1.07-2.65]).


CONCLUSIONS
A change in BMI is associated with ostomy-related problems among long-term CRC survivors. Equipment and care practices may need to be adapted for changes in abdominal shape. Health care providers should caution that a significant increase or decrease in BMI may cause ostomy-related problems.
University of Arizona Cancer Center, Tucson, AZ, USA.
Raymond
R
Skeps
Carmit K
CK
McMullen
Christopher S
CS
Wendel
Joanna
J
Bulkley
Marcia
M
Grant
Jane
J
Mohler
Mark C
MC
Hornbrook
Robert S
RS
Krouse
Lisa J
LJ
Herrinton
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000009:adverse effects*; D017741:Survivors