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

Virginia Sun, Marcia Grant, Christopher S. Wendel, Carmit K. McMullen, Joanna E. Bulkley, Andrea Altschuler, Michelle Ramirez, Carol M. Baldwin, Lisa J. Herrinton, Mark C. Hornbrook, Robert S. Krouse

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)4317-4324
Number of pages8
JournalAnnals of Surgical Oncology
Volume22
Issue number13
DOIs
StatePublished - Dec 1 2015

Fingerprint

Social Adjustment
Survivors
Colorectal Neoplasms
Ostomy
Quality of Life
Hope
Colorectal Surgery
Appetite
Focus Groups
Survival Rate
Interviews
Exercise
Diet

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Sun, V., Grant, M., Wendel, C. S., McMullen, C. K., Bulkley, J. E., Altschuler, A., ... Krouse, R. S. (2015). Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors. Annals of Surgical Oncology, 22(13), 4317-4324. https://doi.org/10.1245/s10434-015-4731-9

Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors. / Sun, Virginia; Grant, Marcia; Wendel, Christopher S.; McMullen, Carmit K.; Bulkley, Joanna E.; Altschuler, Andrea; Ramirez, Michelle; Baldwin, Carol M.; Herrinton, Lisa J.; Hornbrook, Mark C.; Krouse, Robert S.

In: Annals of Surgical Oncology, Vol. 22, No. 13, 01.12.2015, p. 4317-4324.

Research output: Contribution to journalArticle

Sun, V, Grant, M, Wendel, CS, McMullen, CK, Bulkley, JE, Altschuler, A, Ramirez, M, Baldwin, CM, Herrinton, LJ, Hornbrook, MC & Krouse, RS 2015, 'Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors', Annals of Surgical Oncology, vol. 22, no. 13, pp. 4317-4324. https://doi.org/10.1245/s10434-015-4731-9
Sun, Virginia ; Grant, Marcia ; Wendel, Christopher S. ; McMullen, Carmit K. ; Bulkley, Joanna E. ; Altschuler, Andrea ; Ramirez, Michelle ; Baldwin, Carol M. ; Herrinton, Lisa J. ; Hornbrook, Mark C. ; Krouse, Robert S. / Dietary and Behavioral Adjustments to Manage Bowel Dysfunction After Surgery in Long-Term Colorectal Cancer Survivors. In: Annals of Surgical Oncology. 2015 ; Vol. 22, No. 13. pp. 4317-4324.
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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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