Changes in body mass index and stoma related problems in the elderly

Abstract Objectives 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 (> 5 years post-diagnosis) colorectal cancer (CRC) survivors. Materials and 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% ≥ 65 years 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 30 min 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]). Conclusion 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.