Eating behavior patterns in patients after abdominal cancer

BACKGROUND: Eating behavior disorders in patients with an intestinal stoma after radical treatment of colorectal or gastric cancer represent a serious problem affecting quality of life and nutritional status.

AIM: This study aimed to determine the distribution and key factors of eating behavior disorders in patients after abdominal oncologic surgery depending on the presence of an intestinal stoma.

METHODS: A cross-sectional comparative study included 30 patients divided into two comparable groups: 15 patients with an intestinal stoma and 15 patients without a stoma. Data collection involved a set of methods: the SCOFF questionnaire (Sick, Control, One stone, Fat, Food) for screening eating disorders; the Hospital Anxiety and Depression Scale (HADS); and a semi-structured interview.

RESULTS: Patients with a stoma demonstrated a significantly higher prevalence of SCOFF-positive screening results (60% vs 20%; p = 0.020), clinically relevant anxiety (53.3% vs 13.3%; p = 0.020), and depression (33.3% vs 6.7%; p = 0.069). Qualitative analysis in stoma patients revealed a predominance of fear of somatic consequences (93.3%), strict dietary restrictions (86.7%), food anhedonia (80.0%), and avoidant behavior (80.0%). Multivariate regression analysis identified the main predictors of eating behavior disorders, namely body image disturbance (β = −3.15; p < 0.001), fear of social catastrophe (β = −2.80; p < 0.001), and nutritional deficiency (β = −2.25; p = 0.001). This model explained 68% of the variance in eating behavior disorders (R² = 0.68; p < 0.001).

CONCLUSION: Eating behavior disorders in patients with an intestinal stoma have a complex biopsychosocial nature. Rehabilitation requires a multidisciplinary approach including psychological correction of body image disturbances, social anxiety, and nutritional support.