This study will examine the use of distal feeding (a method of feeding patients through the ileostomy formed after surgery) to see if this has a beneficial effect on the resting bowel’s microbiome and therefore delivers a greater chance of a successful reversal of the stoma.
The study will recruit patients who have small bowel stomas (ileostomies) and have small bowel resting who will be fed with either chyme (a liquified food solution) or a special nutritional product (Vital 1.5). The study will measure changes in the microbiome and functional changes, as well as the patients’ quality of life. The outcomes from this research in 20 patients will enable doctors to decide upon the value of a large scale trial.
The research team
The study is being led by Stella Dilke, a Clinical Research Fellow at St Mark’s Hospital in Harrow.
Why is there a need to improve outcomes after bowel surgery?
Resting the bowel is often necessary after surgery to ensure that the bowel that has been re-joined heals properly. However, being effectively “decommissioned” can bring other problems in terms of bowel function and studies have shown that resting in this way can actually damage the bowel, in some cases leading to dehydration or kidney failure.
Usually a stoma will be reversed as soon as possible to avoid damage but this is not always possible. This study aims to see if maintaining the resting bowel through use of special nutritional preparations that mimic the natural process of food moving through the gut can prevent damage and long term problems.
If this study is promising, the team will go on to seek further funding for a large national trial involving potentially hundreds of patients.