Perfil nutricional de colostomizados e ileostomizados em decorrência do câncer colorretal

Abstract

When it is necessary to temporarily or permanently divert the feces to an external opening in the abdominal wall, an intestinal stoma is made by surgical procedure. Colorectal cancer is the leading cause of ostomy and its incidence is increasing worldwide. There is a lack of adequate knowledge about feed and nutrition for people with stoma, which limits specific behaviors. This work described the nutritional profile of intestinal ostomized with emphasis on clinical, anthropometric, biochemical and dietary assessments, comparing the differences between colostomy and ileostomy patients assisted by the Service of Attention to the Health of the Person Ostomized in Juiz de Fora – MG. Clinical data were obtained by consulting the patients charts. A sociodemographic questionnaire was applied and the anthropometric profile was determined by electrical bioimpedance, stature, arm circumference and tricipital skinfold and classified according to the literature. In the biochemical analysis we investigated the following parameters: hemogram, total cholesterol and fractions, triglycerides, blood glucose, basal insulin, glycated hemoglobin, lactose tolerance, serum magnesium, serum potassium, serum sodium, total proteins and fractions, serum ferritin, homocysteine, intact parathormone molecule, folic acid, vitamin A, vitamin E, vitamin K and 25-hydroxyvitamin D; the feces were also evaluated for the presence of alpha-1-antitrypsin and fat. In order to evaluate dietary habits, some questions were asked and the quantitative food frequency questionnaire was applied. The cross-sectional study involved the participation of 44 intestinal ostomized, being 29 colostomy and 15 ileostomy. The average age of the participants was 61.8 years being 50% male. The mean BMI was classified as overweight for adults and the elderly people (25.7 kg / m² and 27.6 kg / m², respectively). The arm circumference and arm muscle circumference were significantly lower in the patients with ileostomy (p = 0.004 and p = 0.050, respectively). Biochemical tests found a 75% frequency of lactose intolerance in study participants. The other exams do not show differences between the groups evaluated. The fecal fat was identified in 4 (26.6%) ileostomy patients and, only one participant, presented loss of protein in the feces. With the help dietary assessment it was possible to identify that the majority of ostomized exclude one or more foods from their dietary routine for fear of changes that may cause in intestineal function. The food frequency questionnaire showed no differences between averages of energy intake and nutrients between people with ileostomy and colostomy, but identified low intake of calcium, magnesium, vitamin B6, vitamin B12, retinol (vitamin A), vitamin E and vitamin D, in both groups, based on recommendations for healthy individuals. The shortage of works with nutritional approach of the ostomized makes impossible the orientation directed to this public. The design of the nutritional profile of intestinal ostomized is essential to assist in the wide evaluation, monitoring and provision of adequate information for the group, which are crucial tools to identify and prevent changes related to the nutritional state of intestinal ostomized.