Abstract
Background: There are a growing number of colorectal cancer (CRC) survivors in the United States, many of whom live with a permanent intestinal stoma (ostomy). Bowel function control has tremendous implications to overall health-related quality of life (HR-QOL).
Methods: Long-term (>5 years) CRC survivors with and without ostomies from three Kaiser-Permanente sites (Northwest, Northern California, Hawaii) were surveyed utilizing the City of Hope Quality of Life (mCOH-QOL)-Ostomy , followed by focus groups for patients with higher and lower HR-QOL. We compared HR-QOL for items specific for dietary changes and bowel function. Qualitative research techniques were used to analyze the open-ended questions, with the investigation team coding entries independently, reviewing discrepant codes, and reaching coding consensus.
Results: Two hundred eighty-six ostomate and 395 non-ostomate CRC survivors completed the survey. While more controls felt comfortable with their diet less than one month after operation (48.6% vs 41.3%), a greater proportion took over one year or never felt comfortable with their diet (21.9% vs 18.0%). Ostomates had less problems with constipation (P=0.001), and more with gas (P=0.02) than controls. More cases avoided vegetables (P=0.007), while a greater proportion of controls avoided carbonated beverages (P<0.001) and utilized specialty diets (P=0.03). There were multiple dietary and behavioral changes utilized to control bowel habits, including the timing of eating, exercise, and food avoidance.
Conclusions: CRC survivors utilize multiple techniques to control their bowel function, and thus control their lives. Insight into these methods can lead to meaningful interventions for this population of cancer survivors.
- Received September 11, 2008.
