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4-year PhD Studentship: Dietary advice and intakes among people after stoma reversal


   Faculty of Health Sciences

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  Dr Charlotte Atkinson, Dr Georgia Herbert, Dr Alexandra Mitchell  No more applications being accepted  Self-Funded PhD Students Only

About the Project

Two main types of gastrointestinal stoma are colostomies and ileostomies (formed from the colon or ileum, respectively). They are surgically created openings in the abdomen to enable discharge of faecal contents into a stoma bag. Indications for such stomas include cancer and inflammatory bowel disease. A stoma can be permanent or temporary, and can be surgically reversed after several months, once the bowel has had time to heal.

After stoma reversal, people often experience altered bowel function, with symptoms including urgency and faecal incontinence and substantial adverse effects on quality of life. In a recent systematic review of qualitative studies in rectal cancer survivors after stoma reversal, the most common strategies for managing such symptoms were medication and diet(1). However, similar to our findings among people living with an ileostomy(2), information was often contradictory and the lack of structured/standardised guidance on dietary management led to confusion(1) and patients using trial and error for managing symptoms(3). Little is known about dietary intakes and advice for people who have undergone stoma reversal in the UK.

The purpose of this PhD is to develop a greater understanding of dietary advice and intakes after stoma reversal, to ultimately improve quality of life.

Aims and Objectives

We hypothesise that dietary advice for people who have had their stoma reversed is inadequate and not evidence-based, and adversely affects quality of life.

The objectives are to determine:

  1. What evidence is available in the literature on dietary management and/or interventions in people who have had their stoma reversed
  2. Current practice in regards to dietary advice and support for people who have had their stoma reversed
  3. The attitudes and views towards dietary advice and management among people who have had their stoma reversed
  4. Dietary intakes and bowel symptoms among people who have had their stoma reversed

Methodology

The research will adopt a mixed methods approach, and as such the student will develop skills in a variety of different research techniques. They will be encouraged to attend suitable training courses to develop skills in methods such as systematic reviewing, statistical analysis, questionnaire design, and qualitative research.

The literature on the evidence for dietary management and dietary advice in people who have had their stoma reversed will be systematically reviewed. Data on current advice and support given to patients with respect to dietary intakes following their stoma reversal will be collected via a patient survey and requests for information (potentially via a freedom of information request) from healthcare providers. An observational study of dietary intakes in people after stoma reversal will be conducted, with the potential to also use qualitative interviews to explore the reasons behind dietary choices. Based on these findings, dietary strategies to address issues raised by patients will be developed for testing in future studies.

Keywords

Stoma reversal, diet, nutrition, quality of life

How to apply for this project

This project will be based in Bristol Dental School in the Faculty of Health Sciences at the University of Bristol.

Please visit the Faculty of Health Sciences website for details of how to apply


Funding Notes

This project is open for University of Bristol PGR scholarship applications (closing date 25th February 2022)
The University of Bristol PGR scholarship pays tuition fees and a maintenance stipend (at the minimum UKRI rate) for the duration of a PhD (typically three years but can be up to four years).

References

1. Pape E, et al. Experiences and needs of patients with rectal cancer confronted with bowel problems after stoma reversal: A systematic review and thematic-synthesis. Eur.J.Oncol.Nurs. 54:102018, 2021.
2. Mitchell A, et al. Dietary management for people with an ileostomy: A scoping review, JBI.Evid.Synth. 28;19(9):2188-2306, 2021.
3. Pape E, et al. Impact of low anterior resection syndrome (LARS) on the quality of life and treatment options of LARS-A cross sectional study. Eur.J.Oncol.Nurs. 50:101878, 2021.
4. Reinwalds M, et al. Living with a resected rectum after rectal cancer surgery-Struggling not to let bowel function control life. J.Clin.Nurs. 27(3-4):e623-e634, 2018.
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