PS3-19: The Association Between Body Mass Index and Intestinal Stoma-Related Problems

Abstract

Background: Colorectal cancer (CRC) survivors with an intestinal stoma (or ostomy) may have multiple problems related to their stoma. Some evidence suggests that weight change is linked to increased problems with an ostomy. Aim: To examine the association between BMI and stoma-related problems in a sample of long-term (>5 years post-diagnosis) CRC survivors that received an ostomy. Methods: Long-term CRC survivors from three regions of Kaiser Permanente (Northwest, Northern California, and Hawaii) completed a mailed survey. The response rate for respondents with an ostomy was 53% (283/529). The survey included questions about weight and height at time of surgery and at time of survey, stoma location, stoma-related problems, and time to complete daily stoma care. A gain or loss of BMI between time of surgery and survey was defined as change in BMI of 1.5 points or more. Differences in stoma-related problems were analyzed based on demographic and clinical characteristics. Results: Of the 268 patients with complete data 41.4% (111 of 268) had a stable BMI, 21.3% (57 of 268) had a decrease in BMI, and 37.3% (100 of 268) had an increase in BMI. Younger (<75 years) survivors were more likely to have problems with clothing caused by stoma location (23% vs. 13%, p=.04). The odds that the location of the stoma caused problems, except clothing issues, were two times greater among survivors whose BMI increased compared to survivors with stable BMI (OR=2.21, 95% CI 1.10–4.47). Moreover survivors with either a BMI increase or decrease were more likely to spend more than 30 minutes per day on stoma care than those with stable BMI (OR BMI increase=2.37, 95% CI 1.12–5.03; OR BMI decrease=2.67 95% CI 1.13–6.29). No significant differences in stoma-related problems were noted related to other demographic or clinical measures. Conclusion: Change in BMI is associated with stoma-related problems among long-term colorectal cancer survivors. CRC survivors with an intestinal stoma whose BMI changes may need to adapt equipment and care practices to changes in abdominal shape. Health-care providers should caution patients that significant changes in BMI may lead to stoma-related problems.