Effectiveness of dietary fiber experiential learning on bowel symptom after surgery for colorectal cancer: A randomized controlled trial

Purpose: Patients with colorectal cancer commonly experience postoperative bowel symptoms, and demand dietary and self-care adjustment. Experiential learning (EL) has been effective in promoting dietary management. This study aimed to investigate the effect of dietary-fiber EL on postoperative bowel symptoms in colorectal cancer patients.

Method: A randomized controlled trial was conducted. A total of 66 adults with stage I-III colorectal cancer, being scheduled for surgery were recruited in Taiwan. EL group (n = 34) received gaming-based activities along with routine care after surgery and a follow-up consultation. Bowel symptoms was assessed by Low Anterior Resection Syndrome at baseline, and 1, 3, and 6 months after surgery, with dietary fiber intake measured by the Food Frequency Questionnaire, and knowledge, efficacy and literacy assessed by the Dietary Fiber Food Scale as covariates.

Results: The two groups did not significantly differ at baseline. The mean bowel symptom scores were 16.2, 13.8, and 9.8 at 1, 3 and 6 months, respectively. The generalised estimating equations model indicated that after controlling surgical site, information sources, fiber intake, knowledge, efficacy, literacy and emotion, EL group reported significantly lower bowel symptoms by 8.3 score at 1 month and by 9.9 score at 3 months post-surgery than the routine group. Lower bowel symptoms were linked to an upper surgical site, higher dietary fiber intake and lower emotional distress.

Conclusions: Experiential learning of dietary fiber improved bowel symptoms better than routine patient education alone. Oncology nurses may develop strategies to further implement experiential learning activities in post-surgery colorectal care.