Nutritional status in patients after colectomy
Patients and methods. In 2006–2015, in the Moscow Clinical Scientific and Practical Centre (MCSC) we observed 24 patients with outcomes of colectomy at various terms after surgery, group 1 (n = 14) received hospital treatment at terms of 1 month to 2 years after surgery, group 2 (n = 10) – more than более 2 years after surgery. All patients underwent complex examination that included the NRS 2002 questionnaire to specify the need for nutritional correction, bioimpedance analysis of the body composition, study of short-chain fatty acids in faeces by the method of gas-liquid chromatography on the chromatograph «Crystal 2000 M» with assessment of the activity of microbiota.
Results. The prevalence of nutritional disorders was 71.4% in group 1, 60.0% in group 2. Hypoproteinemia persisted in 28.6% of patients of group 1, signs of anaemia (with sideropenia) occurred equally frequently in both groups – 64.3 and 50.0%. Electrolytic disorders in the form of hyponatremia were found only in 10% of patients of group 2. Blood calcium levels in both groups were within normal values. Comparison of BMI in both groups did not find any significant differences, its values corresponded to the upper limit of the norm. Two types of changes were found in the concentration and profile of SCFA: lower concentrations of total SCFA (3 times below the norm), except for isocaproic acid; proportional decrease of all SCFA that did not depend on the time that passed since surgery. Control of metabolic activity of the small intestine microbiota permitted to
find changes in proteolytically directed microflora and to justify inclusion of antimicrobial preparations in programmes of nutritional rehabilitation to restore the balance of saccharolytic and proteolytic microflora in order to optimize the adaptive processes in the intestines.
Conclusion. Patients with outcomes of colectomy need complex examination and a long-turn follow-up with obligatory control of the activity of microbiota, introduction of microflora correctors in case of its impaired activity, and performance of bioimpedance analysis of the body composition.
Key words: colectomy, gut microbiota, short-chain fatty acids, nutritional correction, bioimpedance analysis of body composition
For citation: Kuz’mina T.N., Kostyuchenko L.N., Smirnova O.A., Sil’vestrova S.Yu. Nutritional status in patients after colectomy. Vopr. dietol. (Nutrition). 2016; 6(1): 28–32.