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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2015

01-12-2015 | Colorectal Cancer

Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors

Authors: Virginia Sun, PhD, RN, Marcia Grant, PhD, RN, FAAN, Christopher S. Wendel, MS, Carmit K. McMullen, PhD, Joanna E. Bulkley, PhD, Andrea Altschuler, PhD, Michelle Ramirez, PhD, MPH, Carol M. Baldwin, PhD, RN, CHTP, AHN-BC, FAAN, Lisa J. Herrinton, PhD, Mark C. Hornbrook, PhD, Robert S. Krouse, MD, FACS

Published in: Annals of Surgical Oncology | Issue 13/2015

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Abstract

Background

Bowel dysfunction is a known complication of colorectal cancer (CRC) surgery. Poor bowel control has a detrimental impact on survivors’ health-related quality of life (HRQOL). This analysis describes the dietary and behavioral adjustments used by CRC survivors to manage bowel dysfunction and compares adjustments used by survivors with permanent ostomy to those with anastomosis.

Methods

This mixed-methods analysis included pooled data from several studies that assessed HRQOL in CRC survivors. In all studies, CRC survivors with or without permanent ostomies (N = 856) were surveyed using the City of Hope Quality of Life Colorectal Cancer tool. Dietary adjustments were compared by ostomy status and by overall HRQOL score (high vs. low). Qualitative data from 13 focus groups and 30 interviews were analyzed to explore specific strategies used by survivors to manage bowel dysfunction.

Results

CRC survivors made substantial, permanent dietary, and behavioral adjustments after surgery, regardless of ostomy status. Survivors who took longer after surgery to become comfortable with their diet or regain their appetite were more likely to report worse HRQOL. Adjustments to control bowel function were divided into four major strategies: dietary adjustments, behavioral adjustments, exercise, and medication use.

Conclusions

CRC survivors struggled with unpredictable bowel function and may fail to find a set of management strategies to achieve regularity. Understanding the myriad adjustments used by CRC survivors may lead to evidence-based interventions to foster positive adjustments after surgery and through long-term survivorship.
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Metadata
Title
Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors
Authors
Virginia Sun, PhD, RN
Marcia Grant, PhD, RN, FAAN
Christopher S. Wendel, MS
Carmit K. McMullen, PhD
Joanna E. Bulkley, PhD
Andrea Altschuler, PhD
Michelle Ramirez, PhD, MPH
Carol M. Baldwin, PhD, RN, CHTP, AHN-BC, FAAN
Lisa J. Herrinton, PhD
Mark C. Hornbrook, PhD
Robert S. Krouse, MD, FACS
Publication date
01-12-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 13/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4731-9

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