Lower ileostomy output among patients with postoperative colorectal cancer after being supplemented with partially hydrolyzed guar gum: Outcome of a pilot study

BACKGROUND: High stoma output is a significant complication after bowel surgery that causes dehydration, resulting in acute kidney injury, electrolyte imbalances, unintentional weight loss, and malnutrition. This study evaluates the postoperative ileostomy output among patients with colorectal cancer after being supplemented with partially hydrolyzed guar gum.

METHODS: This cross-sectional study collected sociodemographic and clinical characteristics, stoma output, and dietary intake upon discharge, hospitalization, and readmission within 30 d of discharge.

RESULTS: A total of 29 participants were recruited, with 72.4% having moderate malnutrition risk. Patients who received partially hydrolyzed guar gum (PHGG) fiber reported lower stoma output with firmer output consistency than patients who received standard care (SC) (P < 0.05 and P < 0.01). Patients who received PHGG achieved higher energy, protein, and soluble fiber intake than did the SC group (P < 0.01) upon discharge. There was a significant inverse association between soluble fiber (PHGG fiber + dietary soluble fiber) intake and ileostomy output (r, -0.494; P = 0.006).

CONCLUSIONS: Partially hydrolyzed guar gum fiber acts as an agent to hold water, reduce the speed of gastrointestinal tract transit, increase effluent viscosity, and potentially decrease water losses. Supplementation with PHGG fiber appeared to minimize ileostomy output and improve clinical outcomes among postoperative ileostomy patients. This needs to be evaluated further with a randomized controlled trial to confirm this preliminary finding.