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New study investigates if four-stage diet improves care for cancer patients with partial bowel blockage

The first participant has joined the trial of a four-stage diet designed to boost food intake for cancer patients who are unable to eat food normally due to a blockage in their bowel.

Patients with partial bowel obstruction who are not able to have surgery are frequently unable to eat normally and suffer from symptoms such as bloating, feeling full up quickly, nausea, vomiting and pain.

The BOUNCED trial has been developed to investigate if the diet can help to reduce these cancer-related symptoms and enable this group of patients to benefit more from the nutrients in their food and drinks.

Depending on the degree of obstruction, patients follow one of four stages – clear fluids, all liquids, puree or soft, sloppy foods – all of which are low in fibre. They can move up and down the stages depending on how they feel on the day, for example, if someone is having abdominal pain or vomiting, they are advised to step back to clear fluids.

It is the brainchild of Mrs Lindsey Allan, a Macmillan Oncology Dietitian from Royal Surrey NHS Foundation Trust. Lindsey was inspired by a patient to develop the diet to improve care for this group of cancer patients at the trust, which is a large referral centre for cancer patients. She based the diet on evidence and recommendations for Crohn’s disease as the problems suffered by people with these two conditions are similar.

Lindsey said: “We know how important good nutrition is to help patients through surgery and cancer treatment. It is also important for patients who aren’t able to have surgery, as the wrong diet can aggravate symptoms such as bloating, feeling full up quickly, feeling sick, vomiting and pain after eating. If we can help them get their diet right, then we can improve their quality of life and even potentially extend it.

I have already been recommending this diet to my patients but we haven’t done any studies to prove it helps.”

The study, which launched last month (March), is funded by GUTs Fighting Bowel Cancer Charity and supported by the National Institute of Health Research. It aims to investigate if patients can reduce their symptoms of bowel obstruction by following the different stages of the diet. The research team also want to see if the diet is easy to follow, can improve quality of life, and if it can reduce admissions to hospital because of bowel blockages.

Lindsey and her co-investigator Dr Agniezska Michael, a consultant oncologist at the Royal Surrey, hope to recruit 30 patients with an inoperable gynae-oncology or colorectal cancer who are diagnosed with partial bowel obstruction either caused by disease spread to the peritoneum or who have a primary tumour causing a blockage. Participants will be recruited over a maximum of two years from Royal Surrey and Frimley Park Hospital.

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