The nutritional impact of colonic stomas in children. A case control study

Abstract

Introduction: Colostomies are fashioned in children for several conditions majority of which are congenital colorectal disorders such as Hirschsprung’s disease and Anorectal malformations. Nutritional deficiencies may be seen in children with colostomies as a result of altered gut function, inadequate food intake and chronic anaemia. To mitigate the risk of poor outcome, identification of such nutritional deficits is warranted and this forms the basis of this study whose main objective was to assess the nutritional impact of colostomies in children. Materials and methods: A descriptive case-control study was carried out in Kenyatta National Hospital between 2015 and 2017 where 80 participants in total were recruited. Children with colonic stomas were assigned as cases (n=40) and those without stomas as controls (n=40). Anthropometric indicators were used to assess the nutritional status of the both groups for comparison. Data was analysed and presented based on nutritional Z-scores. Results : Wasting was significantly more prevalent among in the case group (22.5%) than in the control group (5%), OR = 5.52(95% CI 1.11-27.43), P = 0.037. There was no significant difference in the anthropometric measures of stunting and underweight between the cases and controls. Conclusion: On the basis of both anthropometric measures, colostomies are associated with nutrition deficiencies in children. Identification of these deficits through active nutritional screening may mitigate the risk of poor outcome in children with colostomies.