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Management of complications in patients with an...
Journal article

Management of complications in patients with an ileostomy: an umbrella review of systematic reviews for the EndOTrial Consortium

Abstract

BackgroundStandardized clinical care processes for patients with Crohn’s disease (CD) and a permanent ileostomy (PI) are lacking. The EndOTrial consortium aims to address this gap by developing pathways for care.MethodsIn this umbrella review, we searched major databases for relevant systematic reviews (SRs) or scoping reviews (ScR) published until January 5, 2024. Screening, data extraction, and quality appraisal (AMSTAR 2) were performed by two independent reviewers.ResultsOf 1349 screened papers, 22 reviews met our inclusion criteria, including 20 SRs (eight with meta-analysis) and 2 ScRs. None exclusively focused on PI. Furthermore, nine reviews did not mention patients with inflammatory bowel disease (IBD), and only two reviews included patients with high-output ileostomy, highlighting a large evidence gap. The identified reviews covered six categories with nine types of interventions, including ostomy care pathways, peristomal skin care, patient education, clinical management of high-output stoma, management and prevention of postoperative ileus, dietary and nutritional support, nursing and supporting care, telemedicine, and self-management interventions. Most SRs including nursing interventions for stoma care highlighted nurses’ role in a variety of standard and specialized treatments. Notably, none of the reviews exclusively examined disease recurrence, stoma pouching systems or adhesives, behavioral interventions, or mental health in patients living with ileostomy.ConclusionsEvidence for best practice interventions to treat complications and improve quality of life in patients living with an ileostomy for CD is limited and heterogeneous. These results outline the need for standardized clinical care processes and pathways tailored to the unique needs of this patient population.

Authors

Solitano V; Vuyyuru SK; Yuan Y; Singh S; Narula N; Ma C; Hanzel J; Hutton M; Van Koughnett JA; Rieder F

Journal

International Journal of Colorectal Disease, Vol. 39, No. 1,

Publisher

Springer Nature

Publication Date

January 1, 2024

DOI

10.1007/s00384-024-04714-8

ISSN

0179-1958

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