The Relationship Between Food Consumption and Bowel Symptoms Among Patients With Rectal Cancer After Sphincter-Saving Surgery.

Wen Liu,Hui Juan Lu,Hai Ou Xia,Jian Min Xu,Yu Xia Zhang

doi:10.3389/fmed.2021.642574

Abstract

Dietary self-management is an important strategy for controlling bowel symptoms after sphincter-saving surgery; however, the dietary factors influencing bowel symptoms are not completely clear. This study aimed to explore the relationship between the specific consumption of food components and bowel symptoms. This study applied a cross-sectional study design. Using convenience sampling, a total of 169 patients with rectal cancer after sphincter-saving surgery were selected from a tertiary hospital. Data were collected through three questionnaires, including general and treatment-related questionnaires, the Memorial Sloan Kettering Cancer Center (MSKCC) bowel function scale—Chinese version, and the Food Frequency Questionnaire. Multiple linear regression analysis was used to analyze the collected data. It was found that the consumption of fruit, cholesterol, and protein and the interaction of cereals and milk products were the main dietary factors affecting bowel symptoms in patients after sphincter-saving surgery. The consumption of protein and fruit was negatively correlated with the symptoms of frequent and urgent defecation, and the consumption of fruit and protein was negatively correlated with general bowel function. The consumption of fruit was negatively correlated with the abnormal feeling of defecation, and the interaction between cereals and milk products was positively correlated with the abnormal feeling of defecation. The results of this study provide evidence for medical staff to further develop scientific dietary education programs to relieve bowel symptoms and promote the quality of life of patients in the future. More research is also needed to explore the mechanisms of the effects of different food components on bowel symptoms in patients after sphincter-saving surgery in the future.

Highlights

Colorectal cancer (CRC) is the third most prevalent cancer globally and is among the leading causes of mortality in the world (1)
The qualitative research conducted by Sun et al showed that patients after sphincter-saving surgery reported that food rich in fat could aggravate diarrhea (15); another two studies focusing on the incontinence symptoms of patients reflected that greasy and fried foods were the most common types of food aggravating the burden of fecal incontinence (19, 20)
This study was the first to explore the relationships among the consumption of different food components and bowel symptoms after sphincter-saving surgery

Summary

Introduction

Colorectal cancer (CRC) is the third most prevalent cancer globally and is among the leading causes of mortality in the world (1). Due to changes in the lifestyle and dietary patterns of Chinese residents, the incidence of CRC has increased in recent years (2). Dietary Effects on Defecation Dysfunction cancer treatment, low anterior resection (LAR) with total mesorectal excision (TME) is the gold standard for the treatment of non-disseminated rectal cancer, aiming at saving the sphincter of patients (4). Saving the sphincter does not mean saving its function, and different bowel symptoms frequently emerge after sphincter-saving surgery, such as fecal incontinence, urgent and frequent defecation, laborious defecation, and bowel movements at night. These symptoms are collectively called low anterior resection syndrome (LARS) (5). Defecation dysfunction may be permanent and not temporary, and patients seldom fully recover (10)

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