[How do individualized stoma diets and nutritional counselling in the inpatient setting influence patient adherence...

Postoperative nutrition affects the quality of life of patients after elective ileostomy creation. A high-output stoma (HOS) occurs in 14-31% of cases and is frequently associated with dehydration and increased rehospitalization rates. Existing guidelines only provide general, often less practice-oriented recommendations. The aim of this study was to develop an interdisciplinary, standardized nutritional concept ("ileostomy diet") to optimize perioperative nutrition and patient education.

In this single-center, prospective interventional study, 103 patients undergoing elective ileostomy between July 2022 and November 2024 were included. The intervention consisted of a three-stage, high-protein and low-fiber diet plan, accompanied by individualized nutritional counselling and a detailed information brochure.

The majority of patients were highly satisfied with the nutritional counselling and brochure (satisfaction score ≥ 8/10: 57.3%; good comprehensibility of the brochure: 97.1%). A HOS occurred in 12.6% of participants. Patients with HOS adhered less to the dietary recommendations (76.9% vs. 94.4%; p = 0.027). Preoperatively, 53.8% of patients were classified as malnourished according to nutritional risk screening and 51.9% according to the criteria of the Global Leadership Initiative on Malnutrition.

The structured nutritional concept applied in the present study proved to be well accepted and practical. In particular, the provision of information, both through written material and during individual counselling sessions during the inpatient stay, was rated positively by the patients. To prevent the occurrence of HOS, high patient adherence to the recommendations is essential.